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COLLEGE  OF  PHYSICIANS 
AND   SURGEONS 


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Reference  Library 

Given  by 


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state  3Boar^  lexamtnation  Series. 


QUESTIONS  IN  OBSTETRICS 


ASKED    AT    THE    EXAMINATIONS    HELD    BY   THE 


NEW  YORK  STATE  BOARD  OF  MEDICAL  EXAMINERS, 


COMPLETE,  WITH  REFERENCES  AND  ANSWERS 

TO    EVERY   QUESTION. 


COMPILED    AND    EDITED    BY 

R.  J.  E.  SCOTT,  A.M.,  M.D.,  B.C.L., 

ATTENDING  PHYSICIAN  BELLEVDE  DISPENSARY,  AND  ATTENDING   GYNECOLOGIST 
DEMILT  DISPENSARY,  NEW  YORK. 


/  ^hj^  //-^^ 


LEA   BROTHERS  &  CO., 
NEW    YORK    AND    PHILADELPHIA 


Entered  according  to  the  Act  of  Congress,  in  the  year  1903,  by 

LEA  BROTHERS  &  CO., 
In  the  Office  of  the  Librarian  of  Congress.     All  rights  reserved. 


DORNAN,   PRINTER. 


PREFACE. 


This  series  is  intended  to  aid  medical  students  and 
practitioners  in  preparing  to  pass  the  State  Board  Examina- 
tions. The  volumes  are  of  the  nature  of  neither  text-books 
nor  quiz  compends.  From  the  latter  they  differ  materially  in 
that  they  do  not  contain  questions  which  might  be  asked,  or 
which  ought  to  be  asked,  or  which,  if  asked,  could  be  answered 
from  some  given  text-book.  They  simply  contain  all  the 
questions  which  have  been  asked  and  are  being  asked  at  the 
New  York  State  Board  Examinations,  and  they  thus  give  an 
accurate  idea  of  the  scope  of  the  examination  and  of  the  re- 
quirements of  the  examiners. 

Although  intended  primarily  for  use  by  candidates  pre- 
paring for  the  examinations  held  by  the  New  York  State 
Board,  this  volume  will  also  serve  as  a  guide  for  correspond- 
ing examinations  conducted  elsewhere,  for  a  careful  survey 
of  the  papers  set  in  most  of  the  other  States  will  show  a 
marked  similarity  to  and  almost  monotonous  repetition  of 
the  questions  contained  in  this  volume. 

Students  are  advised  to  use  this  series  as  a  companion 
to  their  text-books,  to  mark  the  questions  they  cannot 
answer  and  to  learn  the  answers  thereto,  to  write  out  in  full 
all  definitions,  tables  of  composition,  etc.,  and  such  other  facts 
as  they  have  found  from  experience  are  likely  to  be  forgotten 
in  the  recitation  room.     For  this  purpose  these  volumes  are 


iv  PREFACE. 

arranged  so  as  to  leave  right-hand  pages  blank  and  are  printed 
on  paper  prepared  for  the  use  of  either  ink  or  pencil.  Upon 
the  eve  of  examination,  students  will  find  a  review  of  the  ques- 
tions in  these  volumes,  in  connection  mth  their  personal  notes, 
an  efficient  and  ready  means  of  preparation  to  successfully 
meet  the  test. 

The  method  adopted  of  supplying  answers  to  questions  by 
citing  references  to  standard  text-books  is  the  outcome  of 
<;areful  thought,  as  furnishing  the  student  with  much  fuller 
information  than  could  be  couched  in  the  few  lines  of  reply 
admissible  in  such  volumes.  In  selecting  works  for  refer- 
ence^ care  has  been  taken  to  choose  those  in  most  general 
use  and  of  unquestioned  authority. 

Appended  to  each  question  is  an  indication  of  the  dates 
upon  which  it  has  been  asked,  thus  showing  its  frequency 
and  relative  importance. 

The  remaining  volumes  of  this  series  are  in  active  prepa- 
ration, and  will  appear  at  an  early  date. 

R.  J.  E.  Scott. 


CONTENTS. 


PAGE 

I.  Female  Generative  Organs  .    .    .    .    .    .18 

1.  External  (Q.  1  to  4). 

2.  Internal  (Q.  5  to  16). 

3.  External  and  Internal  (Q.  17  and  18). 

4.  Malformations  of  the  Uterus  (Q.  19). 

II.  Menstruation  and  Ovulation  .  .  .  .  .20 

1.  Puberty  (Q.  20). 

2.  Menstruation  (Q   21  to  34). 

3.  Ovulation  (Q.  35  to  41). 

4.  Corpus  Luteum  (Q.  42). 

III.  Fecundation;  Development  and  Nutrition  of  the  Ovum      22 

1.  Fecundation  (Q.  43  to  62). 

2.  Development  of  the  Owm  (Q.  63  to  72). 

3.  Changes  in  the  Uterine  Mucosa  following  Impregnation 

(Q.  73  to  78). 

4.  Nutrition  of  the  Ovum  (Q.  79  to  87). 

5.  Embryo  at  Various  Ages  (Q.  88  to  91). 

6.  Changes  in  the  Circulation  at  Birth  (Q   92  and  93). 

IV.  The  Pelvis  (Q.  94  to  108) 27 

V.  TheFcetalHead(Q.  109toll8) 28 

VI.  Changes  in  the  Maternal  Organism  Caused  by  Pregnancy 

(Q.  119  to  128) 29 

VII.  Diagnosis  of  Pregnancy  .  .  .  .  .         .31 

1.  Direct  Diagnosis  (Q.  129  to  157). 

2.  Differential  Diagnosis  (Q.  158  to  163). 

3.  External  Palpation  (Q.  164  to  170). 

4.  Primipara  and  Multipara  (Q.  171  to  175). 

5.  Duration  of  Pregnancy  (Q.  176  to  181). 


vi  CONTENTS. 

PAGE 

VIII.  Hygiene,  Management,  and  Pathology  of  Pregnancy  37 

1.  Hygiene  and  Pathology  (Q.  182  to  189). 

2.  Morning  Sickness  and  Hj'pereniesis  (Q.  190  to  198). 

3.  Pathology  of  the  Urinary  Organs  (Q.  199  to  208). 

4.  Pathology  of  the  Circulatory  System  (Q.  209  to  211). 

5.  Foetal  Diseases  (Q.  212  to  214). 

6.  Hydatidiform  Pregnancy  (Q.  215  to  219). 

7.  Imra-uterine  Death  (Q.  220  to  226). 

IX.  Abortion  and  Premature  Labor  (Q.  227  to  246)         .  .     42 

X.  Ectopic  Gestation  (Q.  247  to  264)  .  .  .  .43 

XI.  Labor:  Its  Clinical  Course,  Mechanism  and  Management    44 

1.  Causes  (Q.  265  to  267). 

2.  Liquor  Amnii:  Its  Functions,  etc.  (Q.  268  to  271). 

3.  Di\dsions.     Phenomena  (Q.  272  to  286). 

4.  General  Management  (Q.  287  to  298). 

5.  Perineal  Stage  (Q.  299  to  314). 

6.  Third  Stage  (Q.  315  to  337). 

7.  Asepsis  and  Antisepsis  (Q.  338  to  345). 

8.  Anaesthetics  (Q.  346  to  359). 

XII.  Management  of  Mother  and  Child     .        .    .54 

1.  Mother  (Q.  360  to  377). 

2.  Child: 

(a)  Asphyxia  (Q.  378  to  390). 

(b)  Eyes  (Q.  391  to  399). 

(c)  Umbihcus  (Q.  400  and  401). 

(d)  Feeding  (Q.  402  and  403). 

(e)  Caput  Succedaneum  (Q.  404  and  405). 

(f)  First  Twenty-four  Hours  (Q.  406). 

(g)  Stillbirth  (Q.  407  and  408). 

XIII.  Mechanism  in  Vertex  Presentations  (Q.  409  to  429)      .     59 

XIV.  Mechanism  in  Face  Presentations  (Q.  430  to  440)  .     61 

XV.  Mechanism  in  Breech,  Knee,  and  Foot  Presentations 

(Q.  441  to  457) 62 

XVI.  Mechanism  in  Transverse  Presentations  (Q.  458  to  469)     64 

XVII.  Dystocia     .........     65 

1.  Definitions;  Tedious  Labor,  and  Inertia  Uteri  (Q.  470 
to  504). 


CONTENTS.  vii 


PAGE 


2.  Premature  Rupture  of  the  Membranes  (Q.  505  to  510). 

3.  Obstructed  Labor  (Q.  511  to  518). 

4.  Hydrocephalus  (Q.  519  to  523). 

5.  Short  Cord  (Q.  524). 

6.  Multiple  Pregnancy  (Q.  525  to  535). 

7.  Precipitate  Labor  (Q.  536  and  537). 

XVIII.  Deformed  Pelvis  and  Pelvimetry       .  ,  .  .71 

1.  Deformed  Pelvis  (Q.  538  to  546). 

2.  Pelvimetry  (Q.  547  and  548). 

XIX.  Prolapse  OF  Funis  (Q.  549  to  559)         .  .  .  .72 

XX.  Inversion  of  the  Uterus  (Q.  560  to  564)      .  .  .73 

XXI.  Rupture  of  the  Uterus  (Q.  565  to  578)         .  .  .74 

XXII.  Placenta  Previa;  Retained  Placenta;  the  Hemor- 
rhages       .  .  .  .  .  .  .  .     75 

1.  Placenta  Prsevia  (Q.  579  to  594). 

2.  Retained  Placenta  (Q.  595  to  602). 

3.  Hemorrhages  (Q.  603  to  629). 

XXIII.  Eclampsia  (Q.  630  to  648) 79 

XXIV.  Obstetric  Surgery     .......     81 

1.  Induction  of  Premature  Labor  (Q.  649  to  667). 

2.  Forceps  (Q.  668  to  696). 

3.  Version  (Q.  697  to  717). 

4.  Cutting  Operations  on  the  Mother: 

(a)  Cesarean  Section  (Q.  718  to  731). 

(b)  Symphyseotomy  (Q.  732  to  738). 

(c)  Episiotomy  (Q.  739). 

5.  Mutilating  Operations  on  the  Child  (Q.  740  to  744) 

XXV.  Complications  of  the  Puerpertum       .  ,  .  .92 

1.  Puerperal  Infection: 

(a)  Sepsis  (Q.  745  to  770). 

(b)  Phlebitis  (Q.  771  to  777). 

(c)  Phlegmasia  Dolens  (Q.  778  to  780). 

(d)  Douches  (Q.  781  to  786). 

(e)  Curettage  (Q.  787  to  789). 

2.  Puerperal  Mania  (Q.  790  to  793). 

3.  Mastitis  and  Mammary  Abscess  (Q.  794  to  801). 


viii  CONTENTS. 

PAGE 

XXVI.    Gynecology 98 

1.  Imperforate  Hymen  (Q.  802  to  805). 

2.  Vaginismus  and  Vaginitis  (Q.  806  to  808). 

3.  Tampons  (Q.  809  to  813). 

4.  Metritis  and  Endometritis  (Q.  814  to  819). 

5.  Displacements  of  the  Uterus  (Q.  820  to  830). 

6.  Tumors  of  the  Uterus  (Q.  831  to  833\ 

7.  Menstrual  Disorders  (Q.  834  to  840). 

8.  Tubal  Disease  (Q.  841  to  844). 

9.  Ovarian  Disease  (Q.  845  to  847). 

10.  Pelvic  Disease  (Q.  848  to  851). 

11.  Sterility  (Q.  852  to  859). 

12.  Gonorrhoea  (Q.  860). 

XXVII.    Miscellaneous         .         .         .         .         .         .         .   105 

1.  Extragenital  Differences  between  Male  and  Female  (Q. 

861  to  863). 

2.  Water  (Q.  864). 

3.  Knee-chest  Posture  (Q.  865). 

4.  Medico-legal  (Q.  866). 

5.  Cases  Attended  (Q.  867  to  870). 


Appendix 107 

Questions  asked  Ja,nuary,  1903  (Q.  871  to  885)    .  .  .   107 

Questions  asked  May,  1903  (Q.  886  to  900)  .        .         .  .109 

Questions  asked  June,  1903  (Q.  901  to  915)  .  .  .111 


OBSTETRICS. 


WORKS  TO  WHICH  THE  REFERENCES  IN  THE 
TEXT  APPLY. 

KING'S  MANUAL  OF  OBSTETRICS.    Ninth  edition. 
CROCKETT'S  GYNECOLOGY. 


Quotations  have  been  made  from  the  folloiving  works: 

JEWETT'S  PRACTICE  OF  OBSTETRICS.  Second  edition 
DUANE'S  MEDICAL  DICTIONARY.     Fourth  edition. 
FINDLEY'S  GYNECOLOGICAL  DIAGNOSIS. 


The  following  abbreviations  are  used  in  the  succeeding  pages. 

et  seg.  =  and  following  (page  or  pages). 

sub  wee  =  under  the  word  (or  article  or  heading). 

Q=  question. 

A  =  answer, 

(17) 


OBSTETRICS 


I.  FEMALE  GENERATIVE  ORGANS. 

1 .  Give  an  anatomical  description  of  the  external  organs  of 
generation  in  the  female,  and  mention  their  several  functions. 
(June,  1897.) 

2.  Describe,  anatomically,  the  external  organs  of  generation 
in  woman,  and  mention  the  function  of  each  organ.  {May, 
1899.) 

3.  Describe  briefly  the  female  external  organs  of  generation, 
mentioning  the  function  of  each.     {May,  1900.) 

Jj..  Give  the  anatomy  of  the  external  organs  of  generation 
in  the  female,  and  mention  the  functions  of  each.    {May,  1902.) 
1  to  4.  King's  Manual  of  Obstetrics,  pages  39  to  43. 

5.  Give  an  anatomical  description  of  the  vagina  and  name 
its  functions.     {September,  1895.) 

6.  Give  an  anatomical  description  of  the  vagina  and  describe 
its  functions.     {January,  1897.) 

7.  Give  an  anatomical  description  of  the  vagina.  State  the 
functions  of  the  vagina.     {September,  1902.) 

5  to  7.  King's  Manual  of  Obstetrics,  pages  43  and  44. 
Functions:  During  copulation  it  receives  the  penis;  during 
parturition  it  becomes  a  part  of  the  birth-canal. 

8.  Describe  the  uterus  and  give  its  relations  to  the  other 
pelvic  organs.     {January,  1902.) 

9.  Describe  the  human  uterus  and  give  its  anatomical  rela- 
tions.    {June,  1893.) 

(18) 


19  OBSTETRICS. 

8  and  9.  King's  Manual  of  Obstetrics,  pages  44  to  48. 

10.  How  is  the  uterus  supplied  with  nerves?    {May,  1895.) 

10.  King's  Manual  of  Obstetrics,  page  53. 

11.  Give  a  brief  anatomical  description  of  the  uterine 
appendages.     {September,  1896.) 

11.  King's  Manual  of  Obstetrics,  pages  48,  49  and  54 
to  57. 

12.  Give  a  brief  anato7nical  description  of  the  female  internal 
organs  of  generation,  and  mention  the  function  of  each, 
{June,  1898.) 

13.  Give  a  brief  anatomical  description  of  the  female  internal 
organs  of  generation,  mentioning  the  function  of  each.  {Sep- 
tember, 1900.) 

14.  Describe,  anatomically,  the  interned  -organs  of  gener- 
ation in  woman,  and  state  the  function  of  each  organ.  {Jan- 
uary, 1900.) 

15.  Describe,  anatomiccdly ,  the  internal  organs  of  gener- 
ation in  the  female,  and  state  the  function  of  each.  {June,. 
1902.) 

16.  Give  an  anatomical  description  of  the  internal  female 
organs  of  generation,  and  state  the  function  of  each  organ, 
{September,  1901.) 

12  to  16.  King's  Manual  of  Obstetrics,  pages  43  to  49; 
54  and  55  to  56. 

17.  Describe  the  female  reproductive  organs.  {November, 
1894.) 

18.  Give  an  anatomical  description  of  the  genital  organs  of 
the  female,  and  state  the  functions  of  each  organ.  (JunCy. 
1901.) 

17  and  18.  See  above,  Q.  1  to  4;  and  Q.  12  to  16. 

19.  Describe  the  mcdformations  of  the  uterus.  {January^ 
1893.) 

19.  Crockett's  Gynecology,  pages  333  to  338. 


20  OBSTETRICS. 


II.    MENSTRUATION  AND  OVULATION. 

20.  What  changes  take  'place  in  the  female  at  puberty? 
(June,  1901.) 

21.  What  conditions  have  a  hearing  on  the  time  of  life 
in  the  female  when  menstruation  first  occur sf    {June,  1894.) 

20  and  21.  King's  Manual  of  Obstetrics,  page  69. 

22.  What  is  menstruation? 

22.  A  periodical  sanguineous  discharge  from  the  uterine 
cavity  occurring  during  the  period  of  woman's  sexual 
activity.  And  King's  Manual  of  Obstetrics,  page  70, 
last  paragraph. 

23.  (a)  Describe  briefly  the  phenomena  of  menstruation. 
(b)  State  the  relation  of  menstruation  to  ovulation  and 
pregnancy.     {January,  1901.) 

24.  (a)  Give  a  description  of  the  physiology  of  menstruation. 
{Jidy,  1893.) 

25.  (a)  Give  a  physiological  description  of  the  phenomena 
of  menstruation.     {June,  1899.) 

26.  (a)  Give  the  stages  of  a  normal  menstrual  cycle.  {Jan- 
uary, 1896.)- 

27.  (c)  Define  menstruation,  and  (a)  describe  its  cliniccd 
course  and  phenomena.     {June,  1895.) 

28.  Give  the  (c)  definition,  (d)  duration,  and  (e)  frequency 
of  menstruation,  together  loith  (a)  the  restdting  changes  in  the 
uterine  mucous  membrane.     {January,  1894.) 

29.  (a)  Give  a  physiologiccd  description  of  menstruation, 
noting  resulting  changes  in  the  uterine  mucous  membrane 
during  the  molimen.     {May,  1897.) 

30.  (a)  Give  a  brief  physiologiccd  description  of  menstrua- 
tio7i,  noting  the  changes  that  occur  in  the  uterine  mucosa  dur- 
ing the  molimen.     {April,  1898.) 

31.  (f)  What  kind  of  mucous  membrane  lines  the  uterus, 
and  (a)  ivhat  changes  does  it  undergo  during  the  catameniaf 
{April,  1896.) 


21  OBSTETRICS, 

32.  (g)  How  soon  after  parturition  should  a  woman  men- 
struate?    {January  J  1895.) 

33.  (h)  What  is  the  menopause,  and  (i)  in  what  manner 
woidd  you  explain  the  theory  that  it  is  a  critical  period  in  a 
woman's  life?     {September,  1894-) 

34.  (a)  Give  a  physiological  explanation  of  menstruation. 
(j)  At  what  period  of  life  does  it  usually  appear,  and  (h) 
when  does  the  menopause  ordinarily  ensue?     {June,  1896.) 

35.  (k)  Define  ovulation,  and  (b)  state  its  relation  to  men- 
struation.    {May,  1902.) 

36.  Give  the  (k)  definition,  (e)  physiology,  and  frequency 
of  ovulation,  and  (b)  state  whether  ovulation  and  menstruation 
are  synchronous.     {April,  1894.) 

37.  (1)  Mention  the  phenomena  attendant  on  rupture  of 
a  Graafian  follicle.     {September,  1902.) 

38.  (I)  What  is  the  mechanism  of  escape  of  the  ovule  and 
(m)  its  transmission  to  the  tubes  and  uterus?     {June,  1893.) 

39.  (1)  What  is  the  mechanism  of  the  escape  of  the  ovule 
and  (m)  its  transmission  to  the  tube  and  to  the  uterus?  {Sep- 
tember, 1897.) 

23  to  39.  (a)  King's  Manual  of  Obstetrics,  page  68;  Crock- 
ett's Gynecology,  page  267 ;  (b)  King's  Manual  of  Obstetrics, 
pages  66  etseq.;  (c)  See  Q.  22;  (d)  Crockett's  Gynecology, 
page  267;  (e)  page  267;  (f)  King's  Manual  of  Obstetrics, 
pages  48  and  46 ;  Note :  The  epithelium  on  the  free  surface 
is  ciliated  columnar;  (g)  Generally  two  to  three  months  if 
she  is  not  nursing  her  child;  and  later,  at  about  seven  to 
eight  months,  if  she  is;  (h)  Crockett's  Gynecology,  page 
269;  (i)  pages  269  to  271;  (j)  King's  Manual  of  Obstetrics, 
page  69;  Crockett's  Gynecology,  page  266;  (k)  King's  Man- 
ual of  Obstetrics,  page  66;  (1)  page  59,  last  paragraph;  pages 
66  and  67;  (m)  During  menstruation  the  fimbriae  of  the 
Fallopian  tube  are  spread  out  over  the  ovary.  The  ciliated 
epithelium,  which  covers  both  aspects  of  the  fimbriae,  creates 
a  current  in  the  serum  which  tends  to  sweep  the  ovum  along 
into  the  tube,  thence  into  the  uterus.  Once  in  the  tube, 
propulsion  is  further  aided  by  peristaltic  movements  of  the 
tube. 


22  OBSTETRICS. 

40.  (a)  Describe  a  fully  developed  ovum.  {Xovemher, 
1894.) 

41.  (a)  Describe  the  human  ovum;  (b)  where  and  how  does 
it  originate?     (January,  1892.) 

40  and  41.  (a)  ''It  is  a  single  cell^  more  or  less  spherical 
in  form,  about  y^  inch  in  diameter,  and  composed  of  yolk, 
a  nucleus,  a  nucleolus,  and  two  enveloping  membranes." 
(Jewett's  Practice  of  Obstetrics.)  (b)  King's  ]\Ianual  of  Ob- 
stetrics, pages  57  et  seq. 

42.  Define  the  corpus  luteurn.  Describe  (a)  the  corpus 
luteum  of  menstruation,  (b)  the  corpus  luteum  of  pregngtncy. 
{June,  1902.) 

42.  King's  Manual  of  Obstetrics,  pages  60  to  62. 

III.   FECUNDATION,   DEVELOPMENT,   AND   NUTRITION 

OF   THE   OVUM. 

4s.  (a)  What  are  spei^natozoa?  (b)  Where  are  they  formed? 
(c)  Describe  their  appearance  and  function.    {June,  1893.) 

44-  (a)  What  are  spermatozoa?  (b)  Where  are  they  formed, 
and  (c)  what  is  their  appearance  and  function?  {November, 
1893.) 

45.  (d)  Describe  the  formation  of  a  spermatozoon,  and  (e) 
state  how  insemination  is  accomplished.     {April,  1898.) 

46.  (f)  Define  insemination,  and  (e)  state  the  conditions 
necessary  to  its  accomplishment.     {April,  1897.) 

47.  (f)  What  is  insemination,  and  (e)  how  is  it  accom- 
plished?    {June,  1899.) 

48.  (f)  Define  insemination,  and  (e)  give  the  physiology 
of  its  accomplishment.     {May,  1900.) 

49.  (f)  Define  insemination,  and  (e)  give  a  physiological 
description  of  its  accomplishment.     {June,  1900.) 

50.  (d)  Explain  the  formation  of  a  spermatozoon:  (c) 
Describe  its  appearance,  state  its  function,  and  (g)  show  how 
it  may  fertilize  an  ovum.     {May,  1897.) 

51.  Give  a  description  of  (c)  spermatozoa  and  (h)  ova,  and 
(g)  a  brief  physiological  account  of  impregnation.  {May, 
1894.) 


23  OBSTETRICS. 

62.  (i)  Describe  the  semen  and  (g)  explain  how  fecundation 
is  attained.     {April,  1896.) 

53.  (c)  Give  the  anatomical  characteristics  of  a  spermatozoon 
and  of  an  (h)  ovum,  (g)  State  how  the  former  may  fertilize 
the  latter.     {January,  1900.) 

dJj..  (g)  Give  the  physiology  of  conception  or  impregnation. 
{January,  1892.) 

55.  {])  What  is  fecundation  and  (g)  how  does  it  take  place? 
{September,  1893.) 

56.  {])  Define  fecundation,  and  (g)  describe  its  physiology. 
{April,  1895.) 

57.  (g)  Give  a  brief  physiological  description  of  the  process 
of  fecundation.     {May,  1898.) 

58.  (g)  Give  a  physiological  description  of  the  phenomena 
of  fecundation.     {May,  1899.) 

59.  (g)  Describe  the  physiology  of  fecundation,  (k)  mention- 
ing essentials  to  the  accomplishment  of  fecundation.  {Sep- 
tember, 1899.) 

60.  (g)  Give  a  brief  description  of  the  physiology  of  fecun- 
dation, (k)  mentioning  the  essentials  to  the  accomplishment 
of  fecundation.     {January,  1901.) 

61 .  (g)  What  is  the  physiology  of  impregnation?  (k)  What 
conditions  are  essential  to  impregnation?     {June,  1901.) 

62.  (g)  Describe  the  process  of  fecundation.    {June,  1902.) 

63.  (j)  Define  fecundation.  (1)  Describe  the  changes  in 
the  ovum  after  fecundation.     {May,  1902.) 

61^..  (g)  Stxite  the  physiology  of  fecundation,  and  (1)  give 
the  successive  changes  that  take  place  in  the  ovum  after  fecun- 
dation.    {September,  1897.) 

65.  (g)  In  what  manner  is  fecundation  accomplished?  (1) 
What  changes  in  the  ovum  folloio  fecundation?    {June,  1898.) 

66.  (g)  Describe  the  fertilization  of  the  ovum,  and  (1)  its 
early  development.     {January,  1899.) 

67.  (g)  Give  a  pyhsiological  description  of  the  fertilization 
of  the  oimm  and  (1)  its  early  development  thereafter.  {Janu- 
ary, 1898.) 


24  OBSTETRICS. 

68.  (1)  Give  the  successive  changes  that  take  place  in  the 
ovum  after  fecundation.     (May,  1895.) 

69.  (1)  Describe  the  changes  that  take  place  in  the  impreg- 
nated ovum  during  its  passage  to  the  uterus.     {April,  1896.) 

70.  (1)  Describe  the  development  of  the  fertilized  ovum  in 
its  early  stages.     (November,  1891.) 

71.  (1)  Describe  the  segmentation  of  the  vitellus.  (June, 
1896.) 

72.  (1)  Describe  the  vitellus,  the  (m)  allantois,  and  (n) 
the  amnion.     (January,  1895.) 

78.  (o)  Give  an  anatomical  description  of  the  internal  organs 
of  generation  in  the  female,  mentioning  their  functions  and 
(p)  describing  the  changes  in  the  uterine  mucosa  that  follow 
fecundation.     (January,  1899.) 

74-  (p)  Describe  the  *changes  in  the  mucous  membrane  of 
the  uterus  during  pregnancy.     (November,  1892.) 

75.  (q)  What  kind  of  mucous  membrane  lines  the  uterus, 
and  (p)  what  changes  in  it  follow  fecundation?  (November, 
1893.) 

76.  (p)  Describe  the  changes  in  the  uterine  mucosa  that 
follow  fecundation.     (September,  1896.) 

77.  (p)  Describe  the  changes  in  the  uterine  mucosa  that 
follow  fecundation.     (June,  1897.) 

78.  (g),  (k)  Describe  the  processes  essential  to  conception, 
and  (r)  relate  the  physiological  changes  that  follow  it.  (Janu- 
ary, 1902.) 

43  to  78.  (a)  "The  fecundating  element  of  the  semen; 
the  male  generative  cells  which  serve  to  impregnate  the 
ovum.  They  consist  of  an  ovoid  head  to  which  is  attached 
a  long,  vibratile  tail.'^  (Duane's  Medical  Dictionary.)  ,  (b) 
In  the  seminiferous  tubules  of  the  testicle;  (c)  King's 
Manual  of  Obstetrics,  page  72;  (d)  ^^Spermatogenesis.  The 
stages  in  the  development  of  the  spermatozoa,  are  as  follows : 
The  spermatogonia  become  enlarged  to  form  the  spermato- 
cytes, and  each  spermatocyte  subdivides  into  two  cells, 
and  each  of  these  again  divides  into  two  spermatids  or 
young  spermatozoa,  so  that  the  spermatocyte  gives  origin 


25  OBSTETRICS. 

to  four  spermatozoa.  The  process  of  spermatogenesis 
bears  a  close  relation  to  that  of  maturation  of  the  ovum. 
The  spermatocyte  is  equivalent  to  the  immature  ovum. 
It  undergoes  subdivision,  and  ultimately  gives  origin  to 
four  spermatozoa,  each  of  which  contains,  therefore,  only, 
one-fourth  of  the  chromatin  elements  of  the  nucleus  of, 
the  spermatocyte.  In  the  process  of  maturation  of  the 
ovum  its  nucleus  divides,  one-half  being  extended  as  the 
first  polar  body.  The  remaining  half  of  the  nucleus  again 
subdivides,  one-half  being  extended  as  the  second  polar 
body.  The  portion  of  the  nucleus  which  is  retained  to 
form  the  female  pronucleus  of  the  now  matured  ovum 
contains,  therefore,  only  one-fourth  of  the  chromatin 
elements  of  the  original  nucleus,  and  thus  the  spermatozoon 
and  the  matured  ovum,  so  far  as  their  nuclear  elements 
are  concerned,  may  be  regarded  as  of  the  same  morpho- 
logical value. '^  (Gray's  Anatomy.)  (e)  King's  Manual  of 
Obstetrics,  pages  72  and  73;  (f)  Insemination  is  here  the 
equivalent  of  fecundation.  See  King's  Manual  of  Obstet- 
rics, page  72;  (g)  page  72;  (h)  See  above,  Q.  40  and  41; 
(i)  King's  Manual  of  Obstetrics,  page  72;  (j)  page  72;  (k) 
A  live  and  healthy  ovum,  a  live  and  healthy  spermatozoon, 
the  entrance  of  the  head  of  the  latter  into  the  former  and 
its  union  with  the  female  pronucleus.  See  King's  Manual 
of  Obstetrics,  pages  72  and  73;  (1)  pages  73  et  seq.;  (m) 
pages  86  and  87;  (n)  page  85;  (o)  See  above,  Q.  12  to  16; 
(p)  King's  Manual  of  Obstetrics,  pages  91  et  seq.;  (q) 
See  Q.  31  (f).     (r)  See  Q.  119  to  128. 

79.  (a)  Describe  the  development  of  the  placenta.     (July, 
1893.) 

80.  (a)   Describe  the  development  of  the  placenta.     (Sep- 
tember, 1897.) 

81.  (a;)    Describe    the   formation  and  development  of  the 
placenta.     {September,  1902.) 

82.  (a)  Give  the  formation  and  development  of  the  placenta. 
{January,  1896.) 

83.  (a)  What  is  the  placenta?    From  what  is  it  formed, 


26  OBSTETRICS. 

what  is  its  structure,  and  (b)  what  are  its  functions?    (April, 
1891) 

84-  (a)  How  is  the  placenta  jorinedf  (b)  What  is  the 
function  of  the  placenta?     {June,  1898.) 

85.  (c)  What  is  the  usual  situation  of  the  placenta?  {June, 
1892.) 

79  to  85.  (a)  King's  Manual  of  Obstetrics,  pages  96  to 
100;  (b)  page  101;  (c)  page  100. 

86.  (a)  What  is  the  umbilical  cord,  and  (b)  how  is  it  formed, 
and  (c)  what  are  its  anatomical  characteristics?  {May, 
1896.) 

87.  (c)  What  structures  compose  the  fully  developed  um- 
bilical cord?     {July,  1893.) 

86  and  87.  (a)  King's  Manual  of  Obstetrics,  page  100;  (b) 
page  100;  (c)  page  100. 

88.  Describe  the  human  embryo  during  the  (a)  second  month, 
during  the  (b)  fifth  month,  and  during  the  (c)  seventh  month, 
giving  size  and  weight.     {September,  1895.) 

89.  Give  the  size  of  the  average  foetus  in  utero  at  the  end  of 
the  (b)  fifth,  (c)  sevejith,  and  (cl)  ninth  months.  {May, 
1895.) 

90.  (e)  At  what  age  does  the  human  foetus  become  viable? 
{June,  1892.) 

91.  (f)  What  indications  of  ptremature  birth  can  be  deter- 
mined in  an  infant?     {September,  1892.) 

88  to  91.  (a)  King's  Manual  of  Obstetrics,  page  587;  (b) 
page  588;  (c)  page  588;  (d)  page  588;  (e)  End  of  the  twenty- 
eighth  week,  on  the  average ;  (f )  King's  Manual"  of  Obstetrics, 
page  588;  see  under  sixth,  seventh,  and  eighth  months. 

92.  What  changes  occur  in  the  foetal  circulation  at  birth? 
{April,  1895.) 

93.  What  changes  take  place  in  the  child's  circulation  at 
the  time  of  birth?     {January,  1896.) 

92  and  93.  King's  Manual  of  Obstetrics,  pages  102  and 
101. 


27  OBSTETRICS 


IV.  THE  PELVIS. 

94.  (a)  Describe  the  pelvis  and  its  several  hones,  and  (b) 
state  how  the  female  pelvis  may  be  distinguished  from  the  male. 
\Septe7nber,  1893.) 

95.  (a)  Describe  the  bony  pelvis,  and  (b)  state  wherein  the 
male  pelvis  differs  from  the  female  pelvis.     (January,  1898.) 

96.  (b)  What  are  the  differences  between  the  male  pelvis 
and  the  female  pelvis?     {June,  1899.) 

97.  (b)  Whoi  are  the  differences  between  the  male  and  the 
female  pelvisf     {May,  1894.) 

98.  (b)  What  are  the  differences  between  the  male  pelvis 
and  the  female  pelvis?     {May,  1896.) 

99.  (b)  Describe  the  anatomical  differences  between  the  bony 
pelvis  of  the  male  and  that  of  the  female?    {May,  1901.) 

94  to  99.  (a)  King's  Manual  of  Obstetrics,  pages  17  to  21; 
(b)  pages  26  and  27. 

100.  Give  the  (a)  bones,  (b)  divisions,  (c)  straits,  and  (d) 
symphyses  of  the  obstetric  pelvis.     {January,  1894-) 

101.  Differentiate  the  (e)  planes  and  (f)  axes  of  the  pelvis, 
and  mention  their  obstetrical  importance.     {May,  1898.) 

102.  What  is  understood  by  the  term  (e)  planes  of  the  pelvis 
as  ordinarily  applied?     {June,  1902.) 

103.  Give  the  (f)  axes,  (g)  curves,  (h)  angle  of  inclination 
to  the  horizontcd,  and  (i)  diameters  of  the  obstetric  pelvis. 
(September,  1894.) 

104'  (i)  Name  and  give  the  length  of  the  diameters  of  the 
inlet  of  the  pelvis.     (May,  1895.) 

105.  (i)  Give  the  names  and  dimensions -of  the  diameters 
of  the  pelvic  inlet.     (May,  1901.) 

106.  (i)  What  are  the  diameters  of  the  pelvic  outlet?  (j) 
How  is  the  pelvic  outlet  bounded?     (April,  1899.) 

107.  (i)  Give  the  approximate  lengths  of  the  diameters  of 
the  bony  pelvis.     (June,  1902.) 

108.  (k)  What  structures  enter  into  the  formation  of  the 
pelvic  floor?     (July,  1893.) 


2S 


OBSTETRICS. 


100  to  108.  (a)  Innominate  bones  (consisting  of  ilium, 
ischimn,  and  pubes),  sacrmii,  coccyx;  (b)  True  and  false 
pelvis;  (c)  Superior  and  inferior;  (d)  Pubic,  sacro-iliac, 
sacro-cocc3^geal ;  (e)  King's  Manual  of  Obstetrics,  page  24; 
(f)  pages  24  and  25;  (g)  page  25;  (h)  page  25;  (i)  pages 
28  and  30.     Jewett's  figures  are  easily  remembered: 


Brim. 

Mid-plane. 

Outlet. 


Anteroposterior. 


4  inches 

5  " 


Oblique. 


Transverse. 


4^  inches 


5  inches 

4i     " 
4       " 


(j)  King's   Manual  of  Obstetrics,  page   22;    (k)  pages  32 
and  33. 

V.  THE  FCETAL  HEAD. 

109.  What  are  the  (a)  fontanelles  of  the  foetal  head?  {June, 
1892.) 

110.  Name  the  (b)  sutures  and  (a)  fontanelles  of  the  foetal 
head.     (November,  1893.) 

111.  (a)  Describe  the  fontanelles  and  (c)  their  diagnostic 
relations.     {November,  1892.) 

112.  (a)  Describe  the  fontanelles  and  (c)  their  diagnostic 
value.     {April,  1894.) 

113.  (a)  Describe  the  fontanelles  and  (c)  state  their  diagnostic 
value.     {January,  1896.) 

114.  (b)  Name  the  foetal  sutures  and  (a)  fontanelles  and 
(c)  give  the  diagnostic  significance  of  the  latter.  {January, 
1895.) 

115.  (d)  Give  the  principal  diameters  of  the  foetal  head  at  ftdl 
term.     {June,  1896.) 

116.  (d)  Give  the  prhicipal  measurements  of  the  foetal  head 
at  term.     {September,  1902.) 

117:  (e)  Give  a  description  of  the  foetal  head  at  full  term. 
{June,  1895.) 

118.  (e)  Give  a  description  of  the  foetal  head  at  term,  and  {c) 
show  the  obstetric  value  of  the  fontanelles  as  a  means  of  diag- 
nosis.    {September,  1897.) 


29  OBSTETRICS, 

109  to  118.  (a)  King's  Manual  of  Obstetrics,  pages  35  to 
37;  (b)  page  35.  (c)  When  diagnosis  by  external  palpation 
is  inconclusive,  the  position  of  the  presenting  vertex  can 
be  determined  b}'  vaginal  examination,  noting  the  relative 
position  of  the  anterior  (quadrilateral)  and  the  posterior 
(triradiate)  fontanelle,  and  the  direction  of  the  sagittal 
suture  joining  the  two.  The  presence  of  one  or  both,  as 
determined  bj^  the  examining  finger,  also  serves  to  distin- 
guish vertex  and  brow  presentations  from  all  others,  (d) 
King's  Manual  of  Obstetrics,  pages  37  and  38.  •  Note :  the 
occipitomental  is  5J  inches,  the  occipitofrontal  4J  inches, 
and  all  the  others  approximately  3 J  inches,  (e)  King's 
Manual  of  Obstetrics,  pages  34  to  39. 

VI.     CHANGES   IN   THE    MATERNAL   ORGANISM    CAUSED 

BY  PREGNANCY. 

119.  What  changes  occur  during  pregnancy  in  the  external 
genitals  and  vagina?     (April,  1893.) 

119.  ^^The  vagina  partakes  of  the  increased  nutritive 
acti^dty  of  pregnancy.  Growing  vascularity  causes  thick- 
ening and  softening  of  the  mucous  membrane,  which 
furnishes  a  more  abundant  secretion.  The  enlarged  vessels 
of  the  venous  plexus  impart  a  bluish  or  violet  color  to  the 
vagina.  The  vagina  is  increased  in  length,  and  though  it 
is  drawn  upward  by  the  uterus  during  pregnancy,  the 
columns  of  the  anterior  wall  frequently  protrude  from 
the  ^Tilva.  The  swollen  papillae  cause  the  mucous  mem- 
brane to  present  a  granular  feel  to  the  examining  finger. 

'^  The  external  genitals  share  in  these  changes.  The 
largely  developed  bloodvessels  and  Ijmiphatics  and  the 
increased  vascular  tension  induce  a  condition  of  softening 
and  infiltration  which  causes  the  ^ailva  to  gape  and  to 
appear  particularly  prominent.  The  venous  turgescence 
gives  to  the  ^ailva  a  dusk}^  hue.  The  increased  vascularity 
results  in  a  condition  of  great  functional  activit}'  on  the 
part  of  the  sweat-glands  and  sebaceous  follicles. 


30  OBSTETRICS. 

"The  pelvic  floor  undergoes  a  downward  displacement 
during  pregnancy,  which  by  the  end  of  gestation  results 
in  nearly  doubling  the  skin-distance  from  symphysis  to 
coccjrx."     (Jewett's  Practice  of  Obstetrics.) 

120.  (a)  Describe  the  changes  in  position  which  the  uterus 
undergoes  during  pregnancy.     {September,  1894-) 

121.  (a)  What  changes  occur  in  the  uterus  during  pregnancy? 
{November,  1891.) 

122.  (a)  Describe  the  pregnant  iderus,  and  (b)  state  how  it 
differs  from  a  normal  womb.     {April,  1895.) 

120  to  122.  (a)  King's  Manual  of  Obstetrics,  pages  119  to 
123;  (b)  page  130. 

123.  When  conception  takes  place,  ichat  changes  occur  in 
the  generative  organs  of  ivoman?     {September,  1901.) 

123.  King's  Manual  of  Obstetrics,  page  130.  See  above^ 
Q.  119  to  122. 

121}..  What  changes  occur  in  the  blood  during  gestation? 
{April,  1896.) 

124.  The  blood  is  increased  in  cjuantity,  chiefly  in  serum 
and  leucocytes;  the  albuminous  constituents  are  generally 
diminished;  fibrinogen  is  also  increased. 

125.  (a)  Describe  the  inammary  glands,  and  (b)  state  the 
changes  that  occur  in  them  during  pregnancy.  {September, 
1902.) 

126.  (b)  What  changes  occur  in  the  breast  during  pregnancy? 
{May,  1893.) 

125  and  126.  (a)  King's  Manual  of  Obstetrics,  pages  63 
to  65;  (b)  pages  117  and  118. 

127.  What  general  changes  occur  in  woman  during  preg- 
nancy?    {November,  1894.) 

128.  Mention  some  of  the  important  effects  of  pregnancy 
on  the  maternal  organism.     {June,  1901.) 

127  and  128.  King's  Manual  of  Obstetrics,  pages  130  to 
132;  and  see  above,  Q.  119  to  126. 


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31  OBSTETRICS. 

VII.  DIAGNOSIS  OF  PREGNANCY. 

1^9.  Define  and  give  the  signs  of  pregnancy.  (November, 
1894.) 

130.  How  would  you  diagnose  pregnancy?    {March,  1893.) 
129  and  130.  King's  Manual  of  Obstetrics,  pages  103  and 

104  et  seq.,  115  and  116  et  seq. 

131.  Mention  the  signs  of  pregnancy,  classifying  them  as 

(a)  presumptive,  (b)  certain.     {May,  1902.) 

132.  (b)  What  are  the  certain  signs  of  pregnancy?  {No- 
vember, 1891.) 

133.  (b)  Name  the  four  most  important  signs  of  pregnancy 
in  the  order  of  their  value.     {January,  1895.) 

134.  (b)  Name  five  of  the  most  important  signs  of  preg- 
nancy, and  (d)  state  the  date  when  they  are  most  available; 
(May,  1895.) 

135.  Describe  the  (b)  certain  and  (a)  presumptive  signs  of 
pregnancy.     (April,  1894.) 

136.  What  are  the  signs  of  pregnancy,  (c)  doubtfid,  (a) 
probable,  and  (b)  certain?     (September,  1892.) 

131  to  136.  (a)  King's  Manual  of  Obstetrics,  page  116; 

(b)  pages  103  and  104  (relative  order:  1,  2,  3,  6,  5,  4)  and 
page  115;  (c)  page  116;  (d)  pages  104  to  115. 

137.  (a)  What  are  the  subjective  signs  of  pregnancy?  (May, 
1893.) 

138.  (a)  What  are  the  subjective  signs  of  pregnancy?  (No- 
vember, 1892.) 

139.  Classify  the  (b)  objective  and  (a)  subjective  signs  of 
pregnancy,  and  state  their  relative  value.     (June,  1897.) 

140.  Mention  the  (a)  subjective  and  (b)  the  objective  signs 
of  pregnancy,  giving  their  respective  values.    (September,  1898.) 

141.  Classify  the  (a)  subjective  and  the  (b)  objective  signs 
of  pregnancy,  and  state  the  relative  value  of  each  sign  and 
group.     (January,  1899.) 

137  to  141.  (a)  King's  Manual  of  Obstetrics,  page  116 
(1,  3,  4,  5,  10),  and  Quickening;  (b)  pages  103  and  104, 
116  (2,  6,  7,  8,  9). 


I      /^ 


V 


32  OBSTETRICS. 

lJi£.  Describe  the  foetal  heart  sounds,  give  their  rate,  and 
state  when  and  where  they  are  best  heard.     {November,  1893.) 

142.  King's  Manual  of  Obstetrics,  pages  104  and  105. 

lJf.3.  Differentiate  uterine  bruit  and  umbilical  souffle.  .  {Sep- 
tember, 1895.) 

143.  King's  Manual  of  Obstetrics,  pages  109  and  115. 

H4.  (a)  What  is  to  be  learned  by  abdominal  auscultation 
in  pregnancy?     {November,  1891.) 

IJfS.  (a)  What  may  be  learned  by  abdominal  auscultation, 
and  (b)  how  is  it  best  performed  in  pregnancy?  {September, 
1897.) 

144  and  145.  (a)  Fcetal  heart  sound;  uterine  murmur; 
funic  souffle;  active  movements  of  foetus,  (b)  King's  Man- 
ual of  Obstetrics,  page  105. 

146.  What  signs  of  pregnancy  are  deterinined  by  the  touch? 
{September,  1892.) 

146.  Presence  of  a  uterine  tumor;  its  size  and  regular 
growth;  quickening;  ballottement ;  intermittent  contrac- 
tions; Hegar's  sign;  softening  of  the  os  and  cervix;  the 
position  of  the  fcetal  parts. 

lJf7.  Make  a  diagnosis  of  the  early  stages  of  pregnancy. 
{January,  1897.) 

148.  How  may  pregnancy  be  recognized  in  the  early  months? 
{January,  1900.) 

149.  How  may  pregnancy  be  recognized  in  the  early  months, 
and  on  what  symptoms  may  the  diagnosis  be  justified?  {Jan- 
uary, 1902.) 

150.  Make  a  diagnosis  of  pregnancy  at  or  before  the  end 
of  the  third  month.     {May,  1899.) 

151.  Make  a  diagnosis  of  pregnancy  before  the  thirteenth 
week,  stating  the  difficulties  or  uncertainties  attending  such  a 
diagnosis.     {April,  1897.) 

152.  Make  a  diagnosis  of  suspected  pregnancy  before  the 
fourteenth  lueek.     {May,  1898.) 


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83  OBSTETRICS. 

153.  Mention  the  most  reliable  signs  of  pregnancy  before 
the  fourth  month.     {June,  1901.) 

147  to  153.  King's  Manual  of  Obstetrics,  page  125. 

154.  Give  a  differential  diagnosis  of  pregnancy  at  the  six- 
teenth week.     (September,  1896.) 

155.  Make  a  differential  diagnosis  of  pregnancy  at  the  fifth 
month.     {May,  1900.) 

154  and  155.  King's  Manual  of  Obstetrics,  pages  125  and 
126  et  seq. 

156.  (a)  Describe  the  size,  structure,  and  vitality  of  the  foetus 
at  the  end  of  the  fifth  month,  (b)  What  are  the  objective  signs 
of  pregnancy  at  this  period?     {April,  1899.) 

157.  How  woidd  you  diagnose  pregnancy  at  (b)  five  months 
a7id  (c)  at  fidl  term?     {June,  1893.) 

156  and  157.  (a)  King's  Manual  of  Obstetrics,  page 
b^^\  for  vitality,  see  page  171;  (b)  page  125;  fc)  page 
126. 

158.  What  conditions  may  be  mistaken  for  pregnancy? 
{March,  1893.) 

159.  What  conditions  are  frequently  mistaken  for  pregnancy? 
How  is  the  differential  diagnosis  made  ?  {September, 
1895.) 

160.  What  pcdhological  conditions  are  often  mistaken  for 
pregnancy?  Hoio  is  a  diagnosis  to  be  established?  {April, 
1899.) 

161.  Given  a  distended  abdomen,  how  woidd  you  differen- 
ticdly  diagnose  pregnancy,  ovarian  disease,  ascites,  and  gaseous 
accumidcdions?     {September,  1892.) 

158  to  161.  King's  Manual  of  Obstetrics,  pages  126  to 
129. 

162.  Make  a  differential  diagnosis  of  pregnancy  at  the 
fifth  month,  and  pelvic  tumor.     {June,  1899.) 

162.  King's  Manual  of  Obstetrics,  pages  126,  127  and 
125. 


34  OBSTETRICS. 

163.  Make  a  diagnosis  by  exclusion  of  asix  months'  pregnant 
uterus.     {September,  1901.) 

163.  King's  Manual  of  Obstetrics,  pages  126  et  seq., 
125. 

164'  (a)  What  may  be  learned  by  abdominal  palpation 
of  the  pregnant  wojnan  after  the  eighth  month?  {May, 
1899.) 

165.  (a)  What  may  be  learned  by  external  palpation  of  the 
pregnant  ivoman  in  the  latter  months,  and  (b)  how  should  it 
be  performed?     {May,  1898.) 

166.  (b)  Make  by  external  {not  bimanual)  palpation  a  diag- 
nosis of  the  foetal  position  in  utero.     {January,  1897.) 

167.  (b)  Make  a  diagnosis  of  the  position  of  the  foetus  in 
utero  at  term  by  external  {not  bimanual)  palpation.  {January, 
1899.) 

168.  (b)  Alake  a  diagnosis  of  the  position  of  the  foetus  in 
utero,  as  determined  by  abdominal  palpation.    {May,  1900.) 

169.  (h)  Make  a  diagnosis  of  the  position  of  the  foetus  in 
utero  at  term,  as  determined  by  external  palpation.  {September, 
1899.) 

170.  (b)  Differentiate  the  positions  of  the  foetus  at  term  as 
determined  by  external  palpation.     {January,  1896.) 

164  to  170.  (a)  Fundus  uteri;  foetal  parts;  foetal  move- 
ments ;  intermittent  contractions ;  ballottement  (external) ; 
also  size;  presentation;  position  of  foetus,  (b)  King's  Manual 
of  Obstetrics,  pages  219  to  226.  Note  in  addition:  '^Small 
parts  few  and  hard  to  find  suggest  an  anterior  position  of 
the 'child;  small  parts  numerous  and  found  near  the  middle 
section  of  the  abdomen  usually  point  to  a  dorsoposterior 
position  of  the  foetus.  If  small  parts  can  be  felt  beyond 
either  end  of  the  foetal  ellijDsoid,  that  end  is  pretty  surely 
the  breech."  Location  of  anterior  shoidder:  ^The  hands  are 
held  firmly  upon  the  abdomen  over  the  sides  of  the  foetal 
head,  and  without  relaxing  the  pressure  moved  toward  the 
trunk.    The  first  obstacle  encountered  is  the  anterior  shoul- 


35  OBSTETRICS. 

der.  It  is  more  surely  identified  by  palpating  it  with  one 
hand  while  the  other  steadies  the  foetus  by  downward 
pressure  upon  the  breech  in  the  direction  of  the  foetal  axis. 
.  .  .  Anterior  shoulder  within  one  or  two  inches  of  the 
median  line  indicates  an  anterior,  several  inches  from  the 
median  line  a  posterior  foetal  position."  (Jewett's  Practice 
of  Obstetrics.) 

171.  (a)  How  would  you  differentiate  between  first  and 
subsequent  j)regnanciesf     {June,  1895.) 

172.  (a)  Give  the  characteristic  or  distinguishing  marks 
of  a  primiparous  and  of  a  multiparous  woman.  (June, 
1897.) 

173.  (a)  Make  a  differential  diagnosis  of  a  primiparous 
and  a  multiparous  woman.     {January,  1898.) 

174.  (a)  How  may  a  diagnosis  be  made  between  a  first 
pregnancy  and  subsequent  pregnancies?  (b)  How  is  the  date 
of  confinement  calculated?     {April,  1899.) 

175.  (a)  How  may  a  diagnosis  be  made  between  a  first 
pregnancy  and  subsequent  pregnancies?  (b)  How  is  the  date 
of  confinement  calculated?     {September,  1901.) 

176.  (b)  HoiD  is  the  date  of  confinement  calculated?  {Jan- 
uary, 1892.) 

177.  (c)  What  is  the  average  duration  of  pregnancy?  (b) 
How  is  it  computed?     {April,  1896.) 

178.  (c)  What  is  the  normal  duration  of  pregnancy?  (d) 
What  are  the  limits  of  its  variation,  and  (b)  how  should  its 
duration  be  calculated?     {June,  1895.) 

179.  (c)  What  is  the  normal  duration  of  pregnancy?  (d) 
Give  the  limits  of  the  variations  of  pregnancy,  and  (b)  state 
how  its  duration  should  be  calctdated.     {June,  1897.) 

180.  (e)  Give  a  brief  synopsis  of  the  signs  by  which  the 
period  of  pregnancy  may  be  ascertained.     {May,  1894.) 

181.  (c)  Give  the  normal  duration  of  pregnancy;  (d)  state  the 
limits  of  its  variations,  and  (f)  whcd  medico-legal  significance 
attaches  to  them?     {April,  1898.) 


36 


OBSTETRICS. 


171  to  181.  (a) 


Primipara. 


Multipara. 


The  fourchette  is  present. 

The  perineuni  is  tense  and  deep. 

The  labia  are  in  apposition. 

The  vagina  possesses  tonicity,  and  is 
rough  and  rugous,  with  a  granu- 
lar feel. 

The  cervix  is  long,  soft,  and  conical; 
the  OS  is  un dilated. 

The  abdomen  is  full,  rounded,  tense, 
and  resisting  to  the  touch. 

Dark,  purphsh-red  striae  appear  late 
in  pregnancy. 

The  breasts  are  full,  firm,  and  sensi- 
tive to  pressure. 

The  nipples  are  usually  small  and 
undeveloped,  or  even  inverted. 

Striae  are  absent  from  the  breast. 


The  fourchette  is  missing. 
The  perineum  is  relaxed  and  prob- 
ably torn. 
The  vulva  is  frequently  patulous. 
The  vagina  is  relaxed  and  smooth. 


The  cervix  is  large,  cyhndrical,  short, 
not  so  soft,  and  probably  lacer- 
ated; the  OS  is  patulous. 

The  abdominal  walls  are  relaxed  and 
non-resisting  to  the  touch;  the 
skin  is  loose  and  wrinkled. 

The  striae  may  be  both  white  and 
liA'id,  the  former  being  present 
from  the  beginning  of  pregnancy. 

The  breasts  are  flabby,  pendulous, 
and  non-sensitive  to  pressure. 

The  nipples  are  large  and  well  devel- 
oped. 

Striae  are  frequently  to  be  found. 


(Borland's  Obstetrics.) 

(b)  King's  Manual  of  Obstetrics,  pages  203  and  204;  (c) 
pages  203  and  585;  (d)  "The  French  law  recognizes  the 
legitimacy  of  the  offspring  when  the  apparent  term  of 
gestation  is  within  300  days.  In  Austria  the  recognized 
duration  of  pregnancy  is  from  240  to  307  days.  In  Eng- 
land and  the  United  States  there  are  no  legal  limits,  but 
the  possible  protraction  of  gestation  is  admitted  by  all 
legal  authority  ....  Several  cases  are  recorded  by 
obstetric  writers  in  which  pregnancy  was  believed  to  have 
continued  319,  324,  332,  and  336  days  respectively  after 
the  last  menstruation.''  (Jewett's  Practice  of  Obstetrics). 
And  see  King's  Manual  of  Obstetrics,  page  585;  (e)  King's 
Manual  of  Obstetrics,  pages  125  and  126;  (f)  pages  585 
and  586;  and  102  and  103;  and  see  (d). 


37  OBSTETRICS. 

VIII.   HYGIENE,  MANAGEMENT,  AND  PATHOLOGY  OF 

PREGNANCY. 

182.  Give  the  (a)  symptojns,  (b)  diagnosis,  (c)  hygiene,  and 
(d)  pathology  of  pregnancy.     {September,  1893.) 

183.  What  is  understood  by  the  (c)  hygiene  of  pregnancy? 
(d)  by  the  pathology?  (e)  In  a  case  of  pregnancy,  how  is  the 
health  of  the  patient  maintained?     (January,  1900.) 

184-  State  what  is  meant  by  the  (c)  hygiene  of  pregnancy, 
and  (e)  give  a  brief  description  of  the  manner  in  which  it  should 
be  put  into  practice.     {June,  1900.) 

182  to  184.  (a)  See  above  Q.  131  to  136;  (b)-See  above 
Q.  129  and  130.  (c)  The  rules  and  conduct  which  should 
be  observed  by  ever}^  pregnant  woman  for  the  preservation 
of  health  and  strength  both  to  herself  and  the  foetus,  and 
also  as  far  as  possible  to  obviate  or  reduce  to  a  minimum 
many  unpleasant  or  harmful  concomitants  incident  to  her 
condition.  See  King's  Manual  of  Obstetrics,  pages  132 
et  seq.  (d)  By  the  pathology  of  pregnancy  is  meant  the 
discussion  of  the  complications  incident  to  pregnancy,  and 
their  effect  on  the  pregnant  woman,  (e)  King's  Manual  of 
Obstetrics,  pages  132  to  134. 

185.  Describe  the  proper  management  of  the  breasts  of  the 
mother  before  labor.     {March,  1893.) 

185.  King's  Manual  of  Obstetrics,  pages  158,  249  and 
250. 

186.  Give  the  pathology  of  pregnancy.     {June,  1894.) 

187.  Name  some  of  the  diseases  of  pregnancy.  {January, 
1893.) 

188.  To  ivhat  diseases  does  pregnancy  predispose?  {May, 
1893.) 

189.  Name  the  diseases  of  pregnancy,  and  give  their  treat- 
ment. State  the  influence  of  ordinary  ailments  on  the  diseases 
of  pregnancy.     {June,  1894.) 

186  to  189.  King's  Manual  of  Obstetrics,  pages  135 
et  seq. 


38  OBSTETRICS. 

190.  (a)  Describe  morning  sickness,  its  causation  and  treat- 
ment.    {April,  1893.) 

191.  (a)  What  is  '^morning  sickness,'^  when  does  it  begin, 
how  long  does  it  usually  continue,  and  what  is  its  causation 
and  treatment?     {June,  1894.) 

192.  (b)  How  shoidd  the  vomiting  of  pregnancy  be  treated? 
(May,  1894.) 

193.  (b)  Give  the  causes,  prognosis,  and  treatment  of  hyper- 
emesis  of  pregnancy.     {June,  1895.) 

194'  (b)  Mention  the  causes  and  describe  the  management 
of  hyperemesis  of  pregnancy,     {January,  1897.) 

196.  {du),  (b)  Differentiate  ordinary  morning  sickness  from 
the  hyperemesis  of  pregnancy,  and  state  how  the  latter  should 
he  managed.     {May,  1898.) 

196.  (a) ,  (b)  What  is  the  difference  in  significance  and  man- 
agement between  the  so-called  morning  sickness  and  the  hyper- 
emesis of  pregnancy?     {June,  1899.) 

197.  (b)  Define  hyperemesis  of  pregnancy  as  distinguished 
from  (a)  the  ordinary  morning  sickness,  and  state  what  should 
he  done  to  relieve  it.     {January,  1901.) 

198.  (a),  (b)  Describe  differentially  the  ordinary  morning 
sickness  and  the  hyperemesis  of  pregnancy,  giving  the  treat- 
ment of  the  latter.     (September,  1901.) 

190  to  198.  (a)  King's  Manual  of  Obstetrics,  page  118; 
(b)  pages  137  to  142. 

199.  To  what  forin  of  morbus  Brightii  are  pregnant  women 
most  liable?  How  ivoidd  you  diagnose  and  treat  it?  {Jan- 
uary, 1892.) 

200.  Give  a  diagnosis  and  general  management  of  morbus 
Brightii  in  a  pregnant.     {March,  1893.) 

201.  How  ivould  you  measure  the  severity  of  interstitial 
nephritis  in  a  pregnant  woman,  and  how  would  you  treat 
such  a  condition?     {April,  1893.) 

202.  When  cdbuminuria  and  oedema  occur  during  preg- 
nancy, what  is  the  treatment  and  the  prognosis?    {May,  1894-) 

203.  What  are  the  causes  of  albuminuria  in  pregnancy? 


39  OBSTETRICS. 

What  does  it  indicate,  and  how  should  it  he  treated?    {June, 
1898.) 

204'  Describe  albuminuria  as  met  with  in  pregnancy. 
Give  the  causes,  symptoms,  and  treatment.    {April,  1899.) 

205.  Give  the  etiology,  symptoms,  and  management  of 
the  albuminuria  of  pregnancy.     {June,  1899.) 

206.  Give  the  etiology,  symptoms,  a7id  management,  as 
best  understood  and  practised  at  present,  of  albuminuria  of 
pregnancy.     {June,  1900.) 

207  Give  the  significance  and  treatment  of  albuminuria 
during  pregnancy.     {June,  1902.) 

199  to  207.  King's  Manual  of  Obstetrics,  pages  143  to 
149. 

208.  What  is  the  cause  of  difficult  and  painful  urination 
during  pregnancy?     {January,  1895.) 

208.  King's  Manual  of  Obstetrics,  pages  149  to  151. 

209.  What  treatment  would  you  advise  for  a  case  of  con- 
tinued menstruation  during  pregnancy?     {May,  1894.) 

209.  If  the  diagnosis  is  correct,  no  treatment  beyond 
rest  in  bed  is  required;  but  the  condition  is  rare.  Suspect 
ectopic  gestation,  placenta  prsevia,  or  abortion. 

210.  Give  the  diagnosis  and  treatment  of  ancemia  and 
chlorosis.     {November,  1892.) 

210.  King's  Manual  of  Obstetrics,  page  159.  To  estab- 
lish the  diagnosis  make  a  blood  examination,  remembering 
that  the  haemoglobin  will  be  diminished  in  chlorosis,  and 
the  number  of  the  red  corpuscles  decreased  in  ansemia. 
Iron  is  indicated  in  chlorosis,  and  arsenic  in  ansemia. 

211.  What  is  uterine  thrombosis,  and  how  should  it  be 
treated  during  pregnancy?     {September,  1894.) 

211.  Clotting  of  the  blood  in  a  uterine  vein,  usually  due 
to  pressure  or  marasmus.  Treatment  consists  mainly  in 
securing  absolute  rest,  on  account  of  the  danger  from 
embolism,  for  at  least  two  weeks  after  all  swelling  has 
disappeared.  If  miscarriage  occurs  spontaneously,  expe- 
dite labor.     If  the  mother  should  die  suddenly,  attempts 


40  OBSTETRICS. 

should  be  made  to  save  the  child,  if  viable.     (Reynolds 
and  Newell.) 

21£.  What  diseases  of  the  mother  are  liable  to  injure  the 
foetus  in  utero?    {November,  1894-) 

212.  Nephritis  (eclampsia),  diabetes,  syphilis,  chorea, 
valvular  heart  disease,  and  all  the  acute  infectious  fevers. 

213.  How  does  constitutional  syphilis  in  the  parents  affect 
the  infant,  and  how  can  you  detect  its  presence  in  the  infant? 
(May,  1893.) 

213.  ^'The  disease  may  be  acquired  from  father  or 
mother,  or  from  both  parents,  the  poison  being  conveyed 
by  the  spermatozoa  of  the  male  or  the  ovum  of  the  female. 
Without  antisyphilitic  treatment  the  spermatozoa  can 
usually  convey  the  syphilitic  poison  during  the  first  year 
after  primary  infection,  and  there  is  great  danger  to  the 
foetus  from  syphilitic  contagion  up  to  the  fourth  year. 
^Tien  the  virus  of  the  disease  is  concentrated,  as  in  cases 
where  both  parents  are  syphilitic,  the  foetus  will  be  at- 
tacked by  the  disease  in  the  uterus,  and  as  a  result  abor- 
tion will  occur  more  or  less  early  in  the  pregnancy. 

"Very  early  syphilis  is  usually  accompanied  by  emacia- 
tion, eruptions  of  bullae,  particularly  upon  the  palms  of 
the  hands  and  the  soles  of  the  feet,  and  an  extreme  degree 
of  coryza,  cracked  and  ulcerated  lips,  and  evidences  of 
visceral  and  bone  disease.  In  the  older  cases  there  may 
be  no  interference  with  nutrition,  and  one  or  two  mucous 
patches  may  be  the  only  active  evidence  of  infection." 
(Jewett's  Practice  of  Obstetrics.) 

2H.  Name  the  diseases  of  'the  foetus  and  its  membranes 
in  utero.     (January,  189 4.) 

214.  Inflammation  of  the  decidual  tissues: — acute  de- 
cidual endometritis;  chronic  decidual  endometritis: — (a) 
chronic  diffuse;  ib)  chronic  polypoid;  (c)  catarrhal.  Hy- 
drorrhoea  gravidarum.  Atrophy  of  decidua;  deficiency 
of  amniotic  fluid;  hydramnios;  hydatid  mole;  infarcts  of 


41  OBSTETRICS. 

placenta;  calcareous  degeneration  of  placenta;  fatty  degen- 
eration of  placenta;  tumors  of  placenta;  cysts  of  placenta; 
placentitis;  syphilis  of  placenta;  malnutrition;  errors  of 
development.     (From  Jewett's  Practice  of  Obstetrics.) 

215.  What  is  meant  by  the  term  hydatid  pregnancy? 
{January,  1895.) 

216.  What  are  uterine  hydatids?  What  are  their  source 
and  treatment?     {May,  1893.) 

217.  What  are  uterine  hydatids?  Give  their  source  and 
treatment.     {June,  1894.) 

218.  Give  a  -pathological  description  of  so-called  hydatidi- 
form  pregnancy  with  its  diagnosis  and  treatment.  {April, 
1898.) 

219.  Give  the  pathology,  diagnosis,  and  treatment  of  so- 
called  hydatidiform  pregnancy.     {September,  1897.) 

215  to  219.  King's  Manual  of  Obstetrics,  pages  196  to 
199. 

220.  (a)  Mention  the  signs  of  probable  fcetal  death  in  utero. 
{June,  1902.) 

221.  (a)  Give  the  symptoms  which  indicate  the  probable 
death  of  the  foetus  in  utero.     {April,  1899.) 

222.  (a)  What  symptoms  would  indicate  the  probable  death 
of  the  foetus  in  utero?     {June,  1896.) 

223.  (a)  Hoio  ivoidd  yon  diagnose  the  death  of  the  foetus  in 
utero?     {May,   1893.) 

224  (a)  What  signs  would  indicate  death  of  the  foetus  prior 
to  labor,  and  (b)  what  should  be  done  in  such  a  condition. 
{November,  1891.) 

225  (a)  Hoio  may  death  of  the  foetus  be  recognized  in  utero 
after  the  period  of  viability?  (b)  What  should  be  done  in  such 
cases?     {September,  1897.) 

226.  (a)  State  diagnostic  symptoms  of  a  dead  foetus  in  utero 
and  (b)  give  the  mangement  of  such  a  condition.     {June, 
1898.) 

220  to  226.  (a)  King's  Manual  of  Obstetrics,  page  175; 
and  427  and  428;  (b)  pages  176  and  428. 


nr^ 


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42  OBSTETRICS. 

IX.   ABORTION  AND  PREMATURE  LABOR. 

227.  Differentiate  the  terms  abortion,  miscarriage,  and  pre- 
mature labor,  applying  them  to  the  three  trimesters  of  preg- 
nancy.    {September,  1898.) 

227.  King's  Manual  of  Obstetrics,  page  171. 

228  (a)  State  the  principal  causes  of  abortion  due  to  general 
maternal  conditions.     {June,  1898.) 

229.  (a)  What  are  the  causes  of  premature  labor  and  (b) 
what  symptoms  presage  itf     {November,  1892.) 

230.  (a)  What  are  the  causes  of  premature  labor?  (b) 
What  symptoms  presage  it?     {November,  189 4.) 

231.  (b)  What  are  the  premonitory  symptoms  of  abortion? 
{January,  1892.) 

232.  (c)  What  are  the  symptoms  of  an  inevitable  abortion? 
{April,  1896.) 

233.  (b)  How  may  threatened  abortion  be  recognized,  and 
(d)  lohat  should  be  done  toward  its  prevention?     {May,  1902.) 

234-.  (a)  State  the  principal  causes  of  premature  labor  {after 
the  thirtieth  loeek) .  (b)  What  symptoms  presage  it,  and  (d) ,  (e) 
how  should  it  be  managed?     {April,  1897.) 

235.  (d)  What  means  should  be  employed  to  prevent  threat- 
ened abortion  during  the  first  three  months  of  pregnancy? 
{January,  1897.) 

236.  (d)  How  may  threatened  abortion  {foetus  non-viable) 
be  prevented?  (e)  How  should  inevitable  abortion  be  man- 
aged?    {January,  1901.) 

237.  (e)  What  is  the  proper  management  of  inevitable  abor- 
tion?    {September,  1896.) 

238.  (e)  What  is  the  proper  management  of  non-preventable 
abortion?     {January,  1900.) 

239.  (e)  State  the  proper  management  of  so-called  non- 
preventable  abortion.     {June,  1900.) 

2Ifi.  (f)  What  is  abortion  and  what  is  its  managernent,  both 
(d)  preventive  and  (e)  curative?     {July,  1893.) 

241.  Give  the  (f)  definition,  (a)  causes,  (b)  diagnosis,  and 


r> 


r 


/  /  -  •     /  / 


.^.^ 


U/J 


V 


43  OBSTETRICS. 

(d),  (e)  indications  for  treatment  of  abortion.  (September, 
1893.) 

2Jf2.  (e)  How  would  you  manage  a  case  of  premature  labor? 
{January,  1894.) 

243.  (e)  How  would  you  treat  a  case  of  premature  labor? 
{September,  1892.) 

244-  (g)  Describe  the  symptoms  and  (h)  gvoe  the  management 
of  an  incomplete  abortion.     {June,  1896.) 

245.  (h)  Give  the  treatment  of  retained  placenta  after  abor- 
tion.    {April,  1898.) 

228  to  245.  (a)  King's  Manual  of  Obstetrics,  page  172; 
(b)  page  173;  (c)  page  174;  (d)  page  176;  (e)  page  177, 
also  page  182;  (f)  page  171;  (g)  page  174;  (h)  page  180. 

246.  What  are  the  immediate  dangers  of  abortion?  {March, 
1892.) 

246.  Hemorrhage,  sepsis  or  sapr^emia,  and  subinvolution. 

X.  ECTOPIC   GESTATION. 

247.  (a)  Give  the  causes  and  (b)  classification  of  ectopic 
pregnancy.     (May,  1895.) 

248.  (b)  What  are  the  varieties  of  extra-uterine  pregnancy? 
(January,  1892.) 

249.  (h)  What  are  the  varieties  of  extra-uterine  pregnancy? 
(April,   1893.) 

250.  (b)  What  are  the  varieties  of  extra-uterine  pregnancy? 
(May,  1898.) 

251 .  (c)  Define  ectopic  gestation,  (b)  Mention  the  varieties 
and  (e),  (h)  give  the  management  of  ectopic  gestation.  (Sep- 
tember, 1902.) 

252.  (c)  Define  ectopic  gestation,  giving  its  fd)  symptoms 
and  (e),  (h)  management.     (September,  1898.) 

253.  (c)  Define  ectopic  pregnancy,  (d)  JVhat  are  its  symp- 
to7ns  and  (a)  how  does  it  occur?     (June,  1898.) 

254.  (d)  What  are  the  symptoms  of  extra-uterine  gestation? 
(March,  1892.) 


44  OBSTETRICS. 

255.  (c)  De-fine  and  (h),  classify  ectopic  pregnancy,  (e),  (h) 
Give  its  treatment.     (June,  1896.) 

256.  How  icould  you  (d)  diagnose  and  (e),  (h)  treat  a  case 
of  extra-uterine  pregnancy?     {June,  1893.) 

257.  Give  the  (d)  symptoms,  diagnosis,  and  (e),  (h)  treat- 
ment, according  to  coriditions,  of  ectopic  pregnancy.  (Sep- 
tember, 1893.) 

258.  (c)  What  is  ectopic  pregnancy?  (f)  Mention  the 
dangers  of  ectopic  pregnancy,  and  {e),  (h)  state  how  it  should 
he  treated.     {June,  1901.) 

259.  (c)  Define  ectopic  pregnancy,  (g)  Give  symptoms 
of  rupture  at  or  before  the  fourteenth  week,  and  (h)  state 
management  in  case  of  such  an  accident.    {April,  1897.) 

260.  (c)  Define  ectopic  pregnancy,  (g)  Give  the  symp- 
toms of  rupture  at  or  before  the  fourteenth  week,  and  (h)  state 
the  proper  mcmagement  of  such  a  condition.     {May,  1899.) 

261.  (c)  Define  ectopic  pregnancy,  (g)  give  the  symptoms 
of  rupture,  and  (h)  describe  the  proper  procedure  when  this 
condition  exists.    {September,  1900.) 

262.  (g)  What  are  the  symptoms  of  rupture  in  ectopic 
pregnancy?  (h)  What  shoidd  be  done  when  such  rupture 
occurs?     {January,  1897.) 

263.  State  the  (d)  diagnosis,  symptoms,  and  (e),  (h)  treat- 
ment of  tubal  pregnancy.     {January,  1895.) 

264.  (f)  What  are  some  of  the  possible  terminations  of  a 
tubal  pregnancy?     {January,  1893.) 

247  to  264.  (a)  King's  Manual  of  Obstetrics,  page  183; 
(b)  page  182;  (c)  page  182;  (d)  pages  184,  189  and  193; 
(e)  page  186;  (f)  pages  183  and  184;  (g)  page  185;  (h) 
pages  186  and  187. 

XI.  LABOR:   CLINICAL  COUBSE,  MECHANISM,  AND 

MANAGEMENT. 

.265.  Describe  the  causes  of  normal  labor.    {January,  1893.) 

265.  King'sManualof  Obstetrics,  page  205;  add :  "Loosen- 
ing  attachment  of  the  ovum.    The  decidua  vera  is  divided 


45  OBSTETRICS. 

into  two  parts.  One  part  consists  of  an  outer,  dense,  mem- 
branous layer  of  large  cells  resembling  pavement  epithe- 
lium; the  other  part,  of  a  layer  of  much  looser  texture  in 
which  are  found  the  large  decidual  glands.  It  is  in  this 
spongy  layer  that  the  separation  of  the  decidua  takes 
place.  In  this  layer  the  trabecule  enclosing  the  spaces  of 
the  network  have  been  observed  to  decrease  in  size  from 
5^  inch  to  YoVo  hich.  The  layer  seems  to  shrivel  and 
thus  to  permit  easj^  separation.  The  occurrence  of  hemor- 
rhage .  .  .  also  tends  to  detach  the  ovum  from  the 
walls  of  the  uterus  and  may  act  to  intensify  the  pains 
already  established.  This  separation  of  the  decidua  from 
the  uterine  wall  makes  the  ovum  in  part  a  foreign  body, 
and  this  explains  the  continuance  of  the  expulsive  efforts/^ 
Also  excess  of  carbon  dioxide  in  the  blood,  distention  of 
the  uterus  hy  the  growing  ovum,  and  mental  impressions. 
(Jewett's  Practice  of  Obstetrics.) 

266.  Describe  the  propelling  forces  in  labor.    {June,  1896.) 

267.  Describe  the  jnechanism  of  expulsion  in  natural  labor. 
{January,  1896.) 

266  and  267.  King's  Manual  of  Obstetrics,  page  205. 

268.  What  are  the  uses  of  the  liquor  amnii?  {January, 
1892.) 

269.  What  is  the  character  of  the  liquor  amnii,  and  what 
are  its  uses?     {November,  1894-.) 

270.  Name  the  functions,  character,  and  relative  quantity 
and  sources  of  the  liquor  amnii.     {April,  1894.) 

271.  What  is  the  liquor  amnii?  Give  its  functions  in 
pregnancy  and  during  labor.     {April,  1899.) 

268  to  271.  King's  Manual  of  Obstetrics,  page  206.  'The 
liquor  amnii  is  a  clear,  serous  fluid,  secreted  within  the 
amniotic  membrane,  specific  gravit}^  1007  to  1028,  an 
alkahne  reaction,  and  a  composition  including  fixed  solids, 
epithelial  scales,  lanugo,  and  other  matters  derived  from 
the  foetus,  besides  water.     It  amounts  to  about  onejor  two 


46  OBSTETRICS. 

pints  at  term^  and  is  probably  largely  derived  by  trans- 
udation from  the  maternal  structures."  (Jewett's  Practice 
of  Obstetrics.) 

272.  What  are  the  precursory  symptoms  of  labor?  (March, 
1892.) 

273.  What  symptoms  precede  the  beginning  of  labor? 
{April,  1895.) 

272  and  273.  King's  Manual  of  Obstetrics,  pages  207 
and  208. 

27 Jf..  How  can  you  distinguish  false  from  true  labor  pains? 
{January,  1893.) 

275.  What  is  the  diagnosis  of  false  from  true  labor  pains? 
{July,  1893.) 

274  and  275.  King's  Manual  of  Obstetrics,  pages  228 
and  206. 

276.  (a)  Into  how  many  stages  is  labor  divided?  {March, 
1893.) 

277.  (a)  Into  what  stages  is  labor  divided,  and  where  do 
these  stages  begin  and  end?     {April,  1893.) 

278.  (a)  Mention  the  several  stages  of  labor,  and  give  the 
phenomenon  marking  the  end  of  each.     {June,  1902.) 

279.  (a)  Into  how  many  stages  is  labor  divided?  (b)  What 
are  the  phenomena  of  each  stage?     {September,  1894.) 

280.  (c)  Define  and  describe  the  management  of  the  first 
stage  of  labor.     {April,  1895.) 

281 .  (b)  Give  a  brief  description  of  the  three  stages  of  labor. 
{June,  1893.) 

282.  (b)  Mention  in  consecutive  order  the  essential  phe- 
nomena of  normal  labor.     {September,  1899.) 

283.  (b)  Mention  in  order  the  essential  phenomena  of 
normcd  labor.     (June,  1900.) 

284.  State  the  (e)  divisions,  (d)  prodromata,  (a)  stages, 
and  (f)  periods  of  labor.     {September,  1893.) 

276  to  284.  (a)  King's  Manual  of  Obstetrics,  page  207; 
(b)  pages  210,  211,  and  212;  fc)  pages  215  to  230;  (d)  pages 
207  and  208;  (e)  True  and  false,     (f)  First  stage:  ten  to 


47  OBSTETRICS. 

fourteen  hours  in  primiparse;  six  to  eight  hours  in multiparse. 
Second  stage:  two  hours  in  priniipar^e;  one  hour  in  mul- 
tiparse.  Third  stage :  twent}^  minutes  (average) .  (Jewett's 
Practice  of  Obstetrics.) 

285.  State  the  causes  of  the  dilatation  of  the  os  and  cervix 
uteri  as  related  to  labor.     (January,  1894.) 

285.  King's  Manual  of  Obstetrics,  page  206.  "In  the 
dilatation  of  the  cervix  three  agencies  are  concerned:  (1) 
Softening  of  the  cervical  tissues;  (2)  the  hydrostatic  press- 
ure of  the  bag  of  waters;  (3)  the  contraction  of  the  longi- 
tudinal fibres  of  the  upper  uterine  segment."  (Jewett's 
Practice  of  Obstetrics.) 

286.  Give  the  character,  situation,  and  cause  of  the  pains 
during  the  first  and  second  stages  of  labor.     {May,  1893.) 

286.  Kmg's  Manual  of  Obstetrics,  pages  210,  21 1  and  212. 

287.  (a)  What  ^preliminary  preparations  would  you  suggest 
for  a  case  of  labor?     {November,  1894.) 

288.  (a)  Give  briefly  some  essential  general  preparations 
for  labor  at  term.     {May,  1902.) 

289.  (b)  Give  full  details  of  how  a  labor  should  be  inanaged 
antiseptically .     {May,  1901.) 

290.  (b)  What  antiseptic  precautions  should  be  employed 
in  the  conduct  of  labor,  and  liow  should  they  be  applied? 
{January,  1902.) 

291.  Describe  the  preparation  of  (c)  the  bed,  (d)  the  ivoman, 
(e)  the  physician,  and  (f )  the  nurse  for  a  case  of  labor.  {April, 
1896.)      . 

292.  (i)  Describe  the  duties  of  the  accoucheur  during 
normal  labor.     {September,  1892.) 

293.  (g)  Describe  the  course  of  a  normal  labor  and  (i)  the 
duties  of  the  accoucheur  during  such  a  labor.    {April,  189^.) 

29 Jf..  (h)  How  should  the  first  examination  be  made  at  the 
bedside  of  a  woman  in  labor?     {April,  1895.) 

295.  (i)  Describe  the  conduct  of  a  normal  labor  in  its 
several  stages.     {June,  1895.) 


48  OBSTETRICS. 

287  to  295.  (a)  King's  Manual  of  Obstetrics,  pages  214 
to  218;  (b)  pages  215  to  217,  and  539  and  540;  (c)  page 
217;  (d)  page  216;  (e)  page  216;  (f)  '^The  nurse  must  be 
no  less  careful  in  all  particulars  than  the  doctor  is  required 
to  be  in  the  observance  of  antiseptic  details.  Her  clothing 
must  be  scrupulously  clean,  and  she  should  wear  wash- 
dresses.  As  an  extra  precaution  she  must  refrain  from 
attendance  on  obstetric  patients  for  a  week  or  more  after 
a  septic  exposure.  During  that  time  her  hands  and  fore- 
arms are  to  be  sterilized  repeatedly,  and  she  should  take 
two  or  three  full  baths,  with  special  pains  to  cleanse  the 
hair.  In  all  cases  the  nurse  makes  an  entire  change  on 
taking  charge  of  a  patient  in  labor.''  (Jewett's  Practice  of 
Obstetrics.)  And  see  (e).  (g)  King's  Manual  of  Obstetrics, 
pages  207  to  213;  (h)  pages  218  to  227;  (i)  pages  214 
to  242. 

296.  Give  the  managertient  of  the  second  stage  of  labor. 
(April,  1896.) 

297.  State  how  the  second  stage  of  labor  should  be  managed. 
(January,  1895.) 

298.  Define  and  describe  the  management  of  the  second 
stage  of  labor.     (September,  1896.) 

296  to  298.  King's  Manual  of  Obstetrics,  pages  230 
(last  line)  to  235. 

299.  (a)  What  is  the  perineum?  (b)  How  is  it  endangered 
in  labor,  and  (c)  how  should  it  be  protected?  (November, 
1894). 

300.  (b)  How  is  the  perineum  endangered  in  labor?  (N'o- 
vemher,  1891.) 

301.  (c)  Describe  the  management  of  the  perineum  after 
the  head  has  descended  on  it.     (May,  1896.) 

302.  (b)  How  is  the  perineum  endangered  in  labor?  (c) 
How  should  it  be  guarded?     (May,  1897.) 

303.  (c)  HoiD  is  the  perineum  best  j^rotected  during  labor? 
(September,  1892.) 


49  OBSTETRICS. 

304.  (c)  Give  the  'prevention  and  (d)  treatment  of  rupture 
of  the  perineum.     {January,  1902.) 

305.  (c)  Give  directions  for  the  protection  of  the  perineum 
during  labor,  (d)  State  what  shoidd  he  done  in  case  of 
laceration  of  the  perineum.     {June,  1897.) 

306.  (b)  Hoio  may  the  perineum  become  jeopardized  in 
labor f  (c)  How  shoidd  it  be  guarded  to  prevent  rupture? 
(d)  What  should  be  done  in  case  it  is  torn?     {June,  1899.) 

307.  (b)  What  conditions  serve  to  jeopardize  the  perineum 
in  labor?  (c)  Stcde  how  the  perineum  should  be  guarded, 
and  (d)  hoio  it  should  be  treated  if  lacerated?  {September, 
1898.) 

308.  (c)  What  precautions  shoidd  be  observed  to  prevent 
laceration  of  the  perineum?  (d)  If  the  latter  he  torn,  when 
and  how  should  it  be  trecded?     {September,  1896.) 

309.  (c)  How  shoidd  the  perineum  he  guarded  in  labor, 
and  (d)  if  lacerated  how  should  it  he  trecded?     {July,  1893.) 

310.  (d)  When  and  how  is  the  perineum  best  restored 
when  injured  during  labor?     {June,  1892.) 

311.  (d)  Describe  the  proper  management  of  a  torn  peri- 
neum. .  {April,  1896.) 

312.  (d)  Describe  the  operation  for  immediate  repair  of 
a  lacerated  perineum.     {September,  1896.) 

313.  (c)  How  should  the  second  stage  of  labor  he  conducted 
in  view  of  preventing  rupture  of  the  perineum?  (d)  What 
should  he  done  in  case  of  such  a  rupture?     {January,  1901.) 

314.  How  should  lacerations  of  the  (e)  uterus  and  (d) 
perineum  occurring  during  labor  he  treated?    {April,  1894.) 

299  to  314.  (a)  King's  Manual  of  Obstetrics,  pages  32 
to  34.  Obstetrically  speaking,  it  is  the  structure  situated 
between  the  vagina  and  the  rectum;  (b)  King's  Manual  of 
Obstetrics,  page  230,  last  line;  (c)  pages  230  to  235;  (d) 
pages  475  and  476;  (e)  pages  470,  472  and  473. 

31-5.  (a)  What  is  the  management  of  the  third  stage  of 
labor?     {May,  1893.) 

316.  (a) .  Describe  the  proper  management  of  the  third 
stage  of  labor.     {January,  1899.) 


50  OBSTETRICS, 

317.  (a)  Describe  the  proper  management  of  the  third 
stage  of  labor.     (January,  1900.) 

318.  (a)  Describe  the  delivery  of  the  placenta  after  the 
method  of  Crede.     (January,  1897.) 

319.  (b)  Define  the  third  stage  of  labor,  and  (a)  state 
how  it  should  be  managed.     (May,-  1896.) 

320.  (a)  Describe  the  proper  method  of  delivering  'the 
placenta  after  labor  at  term.     (September,  1899.) 

321.  (a)  Describe  in  detail  the  Crede  method  of  delivering 
the  placenta.     (January,  1902.) 

322.  (a)  Relate  the  details  of  Crede' s  method  of  expression 
of  the  placenta.     (January,  1896.) 

323.  (c)  Give  the  causes  of  separation  of  the  placenta,  (d) 
State  how  the  placenta  normally  presents  at  the  os  uteri,  (a) 
Describe  the  treatment.     (June,  1894.) 

324.  (a),  (e)  Describe  the  methods  of  removing  the  placenta 
and  ivhen  they  are  appropriate.     (November,  1891.) 

325.  (a),  (e)  Describe  the  methods  of  removing  the  placenta 
and  state  when  each  method  is  appropriate.     (June,  1893.) 

326.  What  are  the  dangers  of  traction  (f)  on  the  child, 
and  (g)  on  the  placenta?     (January,  1895.) 

315  to  326.  (a)  King's  Manual  of  Obstetrics,  pages  237 
(last  line)  et  seq.;  (b)  page  207;  (c)  "After  expulsion  of  the 
child  the  uterus  grows  smaller  by  retraction  and  closes 
about  the  placenta.  TMien  active  contractions  are  again 
resumed  the  placenta  is  gradually  detached.  As  the  seat 
of  placental  attachment  shrinks  during  a  uterine  contrac- 
tion, the  placenta  not  being  sufhciently  retractile  to  accom- 
modate itself  fully  to  the  diminished  area  of  the  placental 
site,  it  is  partially  torn  from  the  uterine  wall  with  each  pain. 
Rarely  it  may  happen  that  the  placenta  is  wholly  separated 
by  the  first  strong  contraction.  The  placenta  will  then 
probably  be  forced  out,  folded  on  itself  from  side  to  side, 
presenting  by  its  edge.  If  the  placenta  is  not  wholh^ 
detached  at  first  expulsive  efforts  a  different  mechanism 
may   obtain.     Detachment   sometimes   takes   place   first 


51  OBSTETRICS. 

over  the  central  portion  of  the  placental  seat.  Then,  as 
the  uterus. relaxes,  a  retroplacental  blood  clot  is  formed. 
With  each  succeeding  contraction  the  area  of  detachment 
is  increased,  and  the  clot  grows  accordingly.  The  liberated 
portion  of  the  placenta  is  thus  thrust  downward  toward 
the  cervical  opening  and  the  after-birth  is  expelled  flatwise 
by  its  amniotic  surface.  When  it  is  extruded,  with  its  edge 
presenting,  the  grasp  of  the  uterus  acts  directly  upon  the 
placenta.  When  it  is  dissected  off  by  the  blood  clot  its 
expulsion  is  partly  due  to  the  extruding  force  propagated 
through  the  retroplacental  blood  clot  during  the  uterine 
contractions.  The  membranes  are  last  to  be  detached.  In 
either  method  of  expulsion  the  placenta  is  thrust  downward 
through  the  rent  in  the  memibranes  and  the  latter  are 
peeled  off  by  traction  of  the  placenta."  (Jewett^s  Practice 
of  Obstetrics.)  See  also  above,  under  A.  265.  (cl)  King's 
Manual  of  Obstetrics,  page  240;  (e)  pages  460  to  462;  (f) 
page  343;  (g)  page  240,  last  two  lines. 

327.  (a)  When  and  how  should  the  cord  be  tied?  {Jan- 
uary, 1894.) 

328.  What  is  the  ^proper  management  of  the  (a)  cord  and 
(b)  umbilicus  in  the  newborn?     {January,  1896.) 

329.  (c)  How  is  the  umbilical  cord  formed?  (d)  Mention 
its  anatomical  characteristics,  and  (a)  state  how  it  should 
be  ligated.     {May,  1899.) 

330.  (c)  Describe  the  formation  of  the  umbilical  cord,  (d) 
state  its  co7istituents  at  term,  and  (a)  describe  its  proper 
ligation.     {September,  1901.) 

331.  Give  the  (c)  formation  and  (d)  anatomical  character- 
istics of  the  umbilical  cord,  and  (a)  describe  its  proper  ligation. 
{September,  1900.) 

332.  (a)  What  general  rule  should  denote  when  the  umbilical 
cord  should  be  tied?  Describe  the  method  of  ligation.  {Jan- 
uary, 1895.) 

333.  (a)  How  soon  after  the  birth  of  the  child  shoidd  the 
umbilical  cord  be  ligated?  Describe  your  method  of  procedure. 
{January,  1892.) 


52  OBSTETRICS. 

334.  Describe  the  (e)  early  important  attention  to  the  new- 
horn,  (a)  including  the  ligation  of  the  cord.     {May,  1900.) 

335.  (a)  Describe  the  "proper  ligature  of  the  umbilical  cord, 
and  in  this  connection  (e)  state  what  important  attention 
should  he  given  to  the  newborn.     (September,  1899.) 

336.  Describe  the  (a)  ligation  of  the  umbilical  cord  and  (e) 
the  first  attention  to  the  neioborn.     (May,  1898.) 

337.  Describe  (e)  the  early  important  attention  to  the  new- 
born, (a)  including  the  ligation  of  the  cord.    (June,  1902.) 

327  to  337.  (a)  King's  Manual  of  Obstetrics,  page  236; 

(b)  pages  244  and  237;   (c)  page  100,  also  85  et  seq.;  (d) 
page  100;  (e)  pages  235  to  237. 

338.  Asepsis  and  antisepsis,  how  applied  in  midwifery? 
(a)  as  regards  the  accoucheur;  (b)  as  regards  the  parturient; 

(c)  as  regards  the  child.     (June,  1892.) 

339.  (a),  (b),  (c)  Give  a  resume  of  obstetrical  asepsis  and 
antisepsis,  (d)  differentiating  the  terms.     (June,  1895.) 

340.  (d)  Define  the  terms  asepsis,  antisepsis,  (a),  (b),  (c) 
Give  their  proper  application  in  the  lying-in  chamber.  (May, 
1896.) 

341 '  (a),  (b),  (c)  How  shoidd  asepsis  and  antisepsis  he 
applied  in  obstetrical  practice?     (September,  1898.) 

342.  (d)  Define  the  terms  asepsis,  antisepsis,  (b)  State 
the  application  of  each  to  the  parturient.     (April,  1897.) 

343.  (d)  Define  the  terms  asepsis  and  antisepsis,  and 
differentiate  the  terms,  (a),  (b),  (c)  State  the  obstetrical  appli- 
cation of  each.     (January,  1899.) 

344-  (a),  (b)  State  how  the  conditions  of  asepsis  and  anti- 
sepsis should  be  maintained  during  labor.     (June,  1902.) 

345.  (a),  (b)  Give  a  summary  of  antiseptic  measures  to  be 
employed  in  the  care  of  a  case  of  labor.     (June,  189 4-) 

338  to  345.  (a)  King's  Manual  of  Obstetrics,  pages  215 
and  216;  (b)  pages  215  and  216;  (c)  pages  235  and  256, 
last  three  lines  of  chapter,  (d)  Asepsis:  Absence  of  patho- 
genic micro-organisms.  Antisepsis:  Destruction  of  patho- 
genic  micro-organisms.      As    usuall}^   applied,    the    term 


53  OBSTETRICS. 

means  the  use  of  vigorous  measures  for  destroying  micro- 
organisms or  inhibiting  their  growth  after  they  have 
secured  lodgement. 

346.  (a)  Discuss  the  obstetrical  use  of  ancesthetics .  (April, 
1895.) 

347.  (a)  What  are  the  indications  for  ancesthesia  in  labor? 
(January,  1892.) 

348.  (a)  State  the  principles  that  should  govern  the  employ- 
ment of  ancesthetics  during  labor.     (January,  1898.) 

349.  (a)  Under  lohat  conditions  is  obstetrical  ancesthesia 
to  be  employed?  (b)  How  should  ancesthetics  be  adminis- 
tered?    (May,  1900.) 

360.  Describe  (a)  the  important  obstetrical  uses  of  ances- 
thetics, (b)  methods  of  administering  them.    (January,  1897.) 

351.  (a)  Under  what  conditions,  and  (b)  in  lohat  manner 
may  ancesthetics  be  employed  in  labor?     (September,  1899.) 

352.  Give  (a)  indications,  (c)  contraindications,  and  (b) 
essential  methods  for  the  employment  of  ancesthetics  in  labor. 
(May,  1897.) 

353.  (a),  (b),  (c)  Give  rules  for  administering  ancesthetics  in 
labor,  stating  when  they  are  indicated.     (May,  1896.) 

354.  (a)  Give  the  indications  for  the  use  of  ancesthetics  in 
labor;  (d)  name  their  effects  on  uterine  contraction,  and  (e) 
on  the  duration  of  labor.     (June,  1894.) 

355.  (a)  Whe7i  and  (b)  hoio  should  chloroform  be  adminis- 
tered during  labor?     (September,  1894.) 

356.  (a)  When  and  (b)  how  should  chloroform  be  given 
during  labor?     (April,  1896.) 

357.  State  the  effects  of  ancesthetics  on  the  (f)  os  uteri, 
(f)  cervix  uteri,  (g)  abdominal  muscles,  (h)  perineum,  and 
(i)  child.     (November,  1894.) 

358.  (c)  What  conditions  may  arise  during  labor  that 
would  contraindicate  the  administration  of  a  general  ances- 
thetic?     (May,  1901.) 

359.  (c)  What  would  contraindicate  the  use  of  ancesthetics 
inlabor?     (May,  1893.) 


54  OBSTETRICS. 

346  to  359.  (a)  King's  Manual  of  Obstetrics,  pages  521 
to  525;  (b)  page  523.  (c)  ''In  the  presence  of  bronchitis, 
ether  is  unsuitable,  owing  to  its  irritant  effect  on  the 
respiratory  mucous  membranes.  In  atheromatous  disease 
it  is  dangerous,  since  it  increases  the  vascular  tension. 
Chloroform  is  to  be  preferred  in  eclampsia  and  in  tetanic 
contraction  of  the  uterus.  .  .  .  The  presence  of  cardiac 
disease  does  not  necessarily  forbid  the  use  of  anaesthetics, 
.  .  .  yet  a  weak  heart  calls  for  special  caution  in  the 
use  of  these  agents."  (Jewett's  Practice  of  Obstetrics.) 
King's  Manual  of  Obstetrics,  pages  522  and  523.  (d) 
' '  When  pushed  beyond  the  stage  of  mere  analgesia,  they 
lessen  the  strength  and  frequency  of  the  uterine  contrac- 
tions." (Jew^ett's  Practice  of  Obstetrics.)  (e)  Generally 
their  employment  lengthens  the  duration  of  labor;  but  in 
nervous  and  apprehensive  patients,  when  used  in  moder- 
ation, they  often  shorten  labor  by  blunting  the  acuteness 
of  the  suffering,  removing  its  inhibitory  action  on  the 
accessory  forces  exerted  by  the  diaphragm  and  abdominal 
muscles,  (f)  Promotes  relaxation  and  dilatation,  (g)  If 
carried  to  surgical  degree,  anaesthetics  abolish  their  func- 
tions; in  minor  degrees,  see  (e)  above,  (h)  Same  as  (f), 
(i)  Predisposes  to  asphyxia  neonatorum. 


XII.   MANAGEMENT  OF  MOTHER  AND  CHILD. 

360.  Give  some  general  directions  for  the  care  of  the  patient 
at  the  close  of  labor.     {September,  1902.) 

360.  King's  Manual  of  Obstetrics,  pages  244  et  seq. 

361.  What  'principal  dangers  may  arise  after  complete 
delivery,  and  hoio  should  they  be  guarded  against?  {May, 
1898.) 

361.  Hemorrhage  and  sepsis.  King's  Manual  of  Ob- 
stetrics, pages  241  to  243  and  450  to  460;  and  see  Q.  338 
to  345. 


55  OBSTETRICS. 

362.  What  attention  to  the  bladder  of  the  mother  is  re- 
quired (a)  during  and  (b)  after  labor?     {January,  1892.) 

363.  (b)  What  general  directions  shoidd  be  observed  in 
passing  the  catheter  on  a  "patient  during  the  puerperal  state? 
{May,  1895.) 

362  and  363.  (a)  King's  Manual  of  Obstetrics,  page  230; 
(b)  page  248. 

36Jf..  What  are  the  after-pains?  State  their  cause,  and 
give  the  treatment.     {March,  1893.) 

365.  What  are  the  ^^ after-pains,^^  and  how  should  they 
he  treated?     {May,  1894.) 

364  and  365.  King's  Manual  of  Obstetrics,  page  247. 

366.  (a)  What  is  the  puerperal  state?  (b)  Describe  the 
changes  of  the  uterus  during  it.     {May,  1894.) 

367.  (b)  What  changes  occur  in  the  uterine  organs  of  a 
healthy  woman  after  parturition?     {June,  1896.) 

368.  (b)  What  is  involution?  (c)  Hoio  long  a  time  is 
usually  required  for  this  process,  and  (d)  ivhat  causes  may 
operate  to  delay  or  prevent  it?     {July,  1893.) 

369.  Define  (b)  involution,  (e)  subinvolution,  (f)  Hoiv 
may  involution  be  promoted?     {January,  1897.) 

370.  (e)  What  is  meant  by  subinvolution  of  the  uterus? 
(d)  What  are  its  causes?  (f)  Give  the  treatment  for  it. 
{March,  1893.) 

371.  (e)  Define  subinvolution  of  the  uterus,  and  state  its 
(g)  effects,  (g)  results,  and  (f)  treatment.     {May,  1901.) 

366  to  371.  (a)  King's  Manual  of  Obstetrics,  page  244; 
(b)  page  53;  (c)  page  53.  (d)  1.  Absence  of  normal  con- 
tractions; 2.  mild  infection  of  endometrium,  (e)  Subinvolu- 
tion =  tardy  or  imperfect  involution,  (f)  1.  Hot  vaginal 
douches;  2.  massage  and  friction  of  fmidus;  3.  small  doses 
of  ergot,  (g)  Chronic  parenchymatous  metritis;  chronic 
endometritis;  displacements  and  flexions  of  uterus;  pro- 
lapse of  uterus;  sterilit}^ 

372.  What  instructions  shoidd  be  given  a  primipara  in 
regard  to  lactation?     {January,  1895.) 


56  OBSTETRICS, 

372.  King's  Manual  of  Obstetrics,  page  252. 

373.  What  is  the  treatment  of  galactorrhoeaf  {September, 
1896.) 

373.  King's  Manual  of  Obstetrics,  page  251. 

37 Jf..  Give  the  management  in  a  case  of  (a)  fiat  or  inverted 
nipples,  (b)  cracked  nipples.     (May,  1901.) 

375.  (b)  What  hygienic  precautions  are  necessary  for 
a  nursing  child  if  the  mother  has  sore  nipples?  {November, 
1894.) 

374  and  375.  (a)  King's  Manual  of  Obstetrics,  page  250; 
(b);page  249. 

376.  (a)  Describe  the  mammary  glands  and  (b)  the  changes 
they  undergo  in  pregnancy,  (c)  When  the  child  is  stillborn 
what  care  shotdd  be  taken  of  the  mother^ s  breasts?  {April, 
1898.) 

376.  (a)  King's  Manual  of  Obstetrics,  pages  63  to65;  (b) 
page  117;   (c)   page  251. 

377.  What  care  does  the  mother  require  after  labor?  {No- 
vember, 1891.) 

377.  King's  Manual  of  Obstetrics,  pages  246  to  249. 

378.  Give  (a)  the  hygiene  and  (b)  the  pathology  of  preg- 
nancy, and  (c)  the  first  care  of  the  newborn.  (September, 
1897.) 

379.  (c)  Give  details  of  the  first  care  of  the  infant.  (Sep- 
Umber,  1893.) 

378  and  379.  (a)  See  above,  Q.  182  to  184,  (c);  (b)  See 
above,  Q.  182  to  184,  (d) ;  (c)  King's  Manual  of  Obstetrics, 
pages  236,  243  and  252. 

380.  What  is  premature  respiration?    (September,  1895.) 

380.  Attempts  on  the  part  of  the  child  at  respiration 
before  the  mouth  and  nose  have  passed  the  vaginal  outlet. 

381.  (a)  What  are  the  causes  of  stillbirth,  and  (b)  hoiu 
should  a  stillborn  child  be  treated?     (November,  1894.) 


57  OBSTETRICS. 

382.  Give  the  (a)  cause  mid  (b)  treatment  of  foetal  asphyxia. 
(April,  1894.) 

383.  Give  the  (a)  causes,  (c)  symjptovis,  and  (b)  treatment 
of  asphyxia  of  the  newborn.     {November,  1891.) 

384'  (b)  Give  the  methods  of  treatment  for  the  resuscitation 
of  an  asphyxiated  newborn  infant.     {January,  1902.) 

385.  (b)  Describe  a  method  of  resuscitation  of  the  new- 
born.    {November,  1893.) 

386.  (b)  Describe  the  methods  of  performing  artificial 
respiration  in  the  newborn.     {July,  1893.) 

387.  (b)  Hoiv  would  you  attempt  to  resuscitate  a  stillborn 
child?     {January,  1893.) 

388.  (b)  What  methods  of  resuscitation  are  available  in 
the  apparently  stillborn?     {September,  1895.) 

389.  (b)  Describe  the  methods  of  resuscitation  in  the  appar- 
ently stillborn.     {January,  1898.) 

390.  (b)  State  hoiv  the  apparently  stillborn  should  be 
managed  with  reference  to  resuscitation.     {June,  1897.) 

381  to  390.  (a)  King's  Manual  of  Obstetrics,  page  577; 
(b)  pages  579  to  584;  (c)  page  578. 

391.  (a)  To  what  diseases  are  the  eyes  of  the  newborn 
most  liable?  What  are  the  (b)  causes  and  (c)  treatment  of 
these  diseases?     {May,  1893.) 

392.  (b)  What  causes  disease  of  the  eyes  of  the  newborn, 
and  (c)  what  is  the  proper  treatment?     {May,  1894.) 

393.  State  the  (b)  causes,  (cl)  prognosis,  (e)  prevejition, 
and  (c)  treatment  of  ophthalmia  neonatorum.    {April,  1898.) 

394.  How  may  ophthalmia  neonatorum  be  (f)  recognized, 
(e)  prevented,  (c)  treated?     {May,  1899.) 

395.  (e)  What  measures  should  be  employed  to  prevent 
ophthalmia  neonatorum?     {May,  1896.) 

396.  State  the  (f)  symptoms  and  (c)  management  of 
ophthcdmia  neonatorum.     {June,  1900.) 

397.  (e)  Whcd  means  shoidd  be  taken  to  jDrevent  ophthcdmia 
neonatorum?  (c)  Give  the  treatment  of  ophthalmia  neona- 
torum.    {January,  1902.) 


58  OBSTETRICS, 

398.  Give  the  (f)  symptoins,  (c)  treatment,  and  (d)  j)rog- 
nosis  of  ojjhthahnia  neonatorum.     {May,  1895.) 

399.  Give  the  (f)  symptoms,  (c)  treatment,  and  (d)  prog- 
nosis of  ophthalmia  neonatorum.     State  its  (b)  causes  and 

(e)  the  means  of  prevention.     {April,  1897.) 

391  to  399.  (a)  1.  Catarrhal  conjunctivitis;  2.  ophthalmia 
neonatorum;  3.  dacryocystitis,  (b)  King's  Manual  of  Ob- 
stetrics, page  255;  (c)  page  255.  (d)  'T'nless  the  inflam- 
mation quickly  subsides,  the  eye  is  irreparably  damaged 
by  ulceration  and  partial  destruction  of  the  cornea." 
(Jewett's  Practice  of  Obstetrics.)  King's  Manual  of  Ob- 
stetrics, page  255;  (e)  page  256,  last  three  lines  of  chapter; 

(f)  page  255. 

4-00.  Discuss  umbilical  hemorrhage.     {May,  1895.) 

Jfll.  How  would  you  treat  hemorrhage  of  the  umbilical  cord? 

{May,  1893.) 
400  and  401.  King's  Manual  of  Obstetrics,  page  255. 

If  end  of  cord  is  bleeding,  simply  re-tie  with  aseptic  ligature. 

4-02.  Describe  your  method  of  artificial  feeding  when  the 
mother  cannot  nurse  the  newly-born  child.    {January,  1894.) 

403.  Describe  the  immediate  care  of  the  newborn  child 
when  for  any  reason  the  mother  cannot  nurse  it.  Give  rules 
for  artificial  feeding.     {June,  1897.) 

402  and  403.  King's  Manual  of  Obstetrics,  pages  251 
and  252. 

404.  (a)  Define  caput  succedaneum.  (b)  Staie  how  it 
is  produced  and  give  its  significance.     {April,  1898.) 

405.  (b)  Give  the  formation  of  the  caput  succedaneum. 
(c)  Where  does  the  caput  succedaneum  appear  in  the  third 
position?     {April,  1899.) 

404  and  405.  (a)  ''An  ceclematous  swelling  which  is 
developed  on  the  presenting  part  in  the  course  of  birth." 
(Jewett's  Practice  of  Obstetrics.)  (b)  ''Dm'uig  a  uterine 
contraction  all  parts  of  the  foetal  mass  are  rmder  pressure 
except  that  which  offers  to  the  examining  finger  "uithin 


59  OBSTETRICS. 

the  girdle  of  resistance.  The  vessels  of  the  presenting 
part  become  engorged  during  the  pains  and  a  serous 
exudate  takes  place  into  the  cellular  tissues  of  that  portion 
of  the  foetal  surface."  ''The  location  of  the  caput  succe- 
daneum  is  of  interest  in  the  examination  of  the  head  after 
delivery  as  indicating  the  position  in  which  the  head  had 
descended.  In  anterior  positions  it  is  situated  at  the  pos- 
terior, and  in  posterior  positions  on  the  anterior  aspect 
of  the  summit  of  the  head.  In  left  positions  it  occurs  to 
the  right,  and  in  right  positions  to  the  left  of  the  median 
line."  (Jewett's  Practice  of  Obstetrics.)  (c)  King  gives 
the  third  position  as  R.  0.  A.,  in  which  case  the  caput 
succedaneum  will  be  found  on  the  posterior  part  of  the  left 
parietal  region.  Jewett  gives  the  third  position  as  R.  0.  P., 
in  which  case  it  will  be  found  on  the  anterior  part  of  the 
left  parietal  region. 

406.  Describe  the  care  of  an  infant  during  the  first  twenty- 
four  hours  after  birth.     {September,  1895.) 

406.  King's  Manual  of  Obstetrics,  pages  243  and  252  et  seq. 

407.  How  would  you  decide  whether  a  dead  infant  had 
been  born  alive?     {March,  1893.) 

408.  If  called  to  a  dead  and  newly-born  infant,  how  could 
you  prove  that  it  was  living  when  born?     {June,  1893.) 

407  and  408.  King's  Manual  of  Obstetrics,  pages  599  to 
601. 

XIII.    MECHANISM  IN  VERTEX  PRESENTATIONS. 

409.  Define  and  differentiate  (a)  position,   (b)  presenta- 
tion, (c)  rotation.     {September,  1898.) 

410.  Differentiate  the  following:  (a)  position,  (b)  presen- 
tation, (c)  rotation.     {September,  1897.) 

411.  Differentiate  the  terms  (a)  position,  (b)  presentation, 
and  (c)  rotation.     {September,  1896.) 

412.  Define  the  folloioing  terms:  (a)  position,  (b)  presen- 
tation, (d)  version,  (c)  rotation.     {April,  1896.) 


4  I 


l^  'S 


d^ 


>■; 


■^T 


J^ 


h.."^"' 


frt' 


^■t.^  i^t'-* 


t   /.*•'  %!«''**^ 


/i 


60  OBSTETRICS. 

409  to  412.  (a)  King's  Manual  of  Obstetrics,  pages  258 
and  609;  (b)  page  608;  Jewett  defines  presentation  ''as  the 
relation  of  the  long  axis  of  the  foetal  ovoid  to  the  uterine 
axis ;''  or  ''the  part  of  the  foetus  which  presents  at  the 
pelvic  brim.''  (c)  King's  Manual  of  Obstetrics,  page  262; 
(d)  page  347. 

Jf-lS.  How  many  ^presentations  of  the  foetus  are  given? 
{March,  1892.) 

41  Jj..  How  many  different  presentations  are  liable  to  he 
met  with  in  obstetrical  practice?  What  are  they?  (Sep- 
tember, 1895.) 

413  and  414.  King's  Manual  of  Obstetrics,  page  256. 

415.  What  are  (a)  the  positions  and  (b)  attitudes  of  the 
foetus  in  utero,  and  what  are  their  causes?    (April,  1893.) 

415.  (a)  King's  Manual  of  Obstetrics,  pages  257,  274, 
286  and  311;  (b)  pages  256  and  258.  ''The  foetal  posture 
is  the  result  partly  of  the  primitive  form  of  the  embryo, 
mainly  of  the  uterine  pressure  forces."  (Jewett's  Practice 
of  Obstetrics). 

416.  How  many  positions  of  the  vertex  are  there?  Name 
and  describe  each.     (September,  1894.) 

416.  King's  Manual  of  Obstetrics,  pages  258  and  259. 

417.  Give  the  usual  (a)  vertex,  (h)  face,  and  (c)  breech 
presentations.     (May,  1895.) 

418.  (a)  Give  the  normal  vertex  presentations  in  the  order 
of  their  frequency.     (September,  1896.) 

419.  (a)  Describe  the  varieties  of  vertex  presentation. 
(June,  1896.) 

420.  (d)  How  is  a  vertex  presentation  recognized  by  pcdpa- 
tion?     (September,  1895.) 

421  (d)  Labor  having  begun,  how  by  abdominal  palpation 
could  a  vertex  presentation  be  recognized?    (April,  1899.) 

422.  (a),  (b)  Name  and  describe  the  various  forms  of  head 
presentation  with  (e)  the  management  appropriate  to  each. 
(June,  1894.) 


61  OBSTETRICS. 

423.  (f)  Give  the  causes  of  cephalic  j/resentation,  and 
state  why  favorable.     {January,  1894.) 

4^4-  (g)  Name  the  fundamental  presentations  in  labor, 
and  (h)  give  the  methods  of  their  diagnosis.  (November, 
1893.) 

425.  (i)  Describe  the  mechanism  of  labor  in  the  first,  or 
left  occipito-anterior  presentation.     (January,  1898.) 

426.  (j)  On  ivhat  signs  may  a  diagnosis  of  occipito^ 
posterior  position  be  based?     {June,  1901.) 

427 .  (h)  Row  would  you  know  a  head  presentation?  How 
a  breech  presentation?  How  a  transverse  presentation? 
(April,  1894.) 

428.  (i)  Give  the  mechanism  of  labor  in  the  first  position 
(L.  0.  A.).     (January,  1899.) 

429.  {'])  How  woidd  you  diagnose,  arid  (e)  manage  a  case 
of  occipito-posterior  presentation?     (September,  1892.) 

417  to  429.  (a)  King's  Manual  of  Obstetrics,  pages  257 
to  259;  (b)  pages  273  to  275;  (c)  pages  287  and  288;  (d) 
pages  219,  269  and  270;  (e)  pages  270  to  272  and  282  et  seq. 
(f)  ^'The  preponderance  of  vertex  presentations  is  clue 
mainly  to  adaptation  of  the  foetal  ovoid  to  the  shape  of 
the  uterus,  and  in  some  degree  to  gravity,  the  cephalic 
being  the  heavier  extremity  of  the  foetus.''  (Jewett's  Prac- 
tice of  Obstetrics.)  (g),  (h)  Head,  see  (d)  above.  Breech, 
King's  Manual  of  Obstetrics,  page  295.  Transverse,  page 
317.     (i)  pages  259  et  seq.     (j)  page  269. 

XIV.    MECHANISM  IN  FACE  PRESENTATIONS. 

430.  Give  the  (a)  frequency,  (b)  causes,  (c),  (d)  diagnosis, 
(e)  mechanism,  and  (f)  treatment  of  face  presentation.  (No- 
vember, 1894') 

43 L  (g)  Mention  the  varieties  of  face  presentation.  State 
the  (h)  prognosis  and  (f)  treatment  of  each  variety.  (Jan- 
uary, 1902.) 

432.  Give  the  diagnosis  of  face  presentation  fc)  before 
rupture,  fd)  after  rupture  of  the  membranes.     (April,  1899.) 


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62  OBSTETRICS. 

433.  (e)  Give  the  mechanism  of  a  face  ^presentation.  (May^ 
1894.) 

434.  Give  the  (c),  (d)  diagnosis  and  (f)  management  of  a 
face  presentation.     (November,  1891.) 

435.  (g)  Describe  face  presentation,  its  (c),  (cl)  diagnosis 
and  (f)  management.     {January,  189 4-) 

436.  State  how  a  face  presentation  may  be  (c),  (d)  recog- 
nized and  (f)  rectified.     (September,  1898.) 

437.  State  hoiv  a  face  presentation  may  be  (c),  (d)  recog- 
nized and  (f)  managed.     [January,  1900.) 

438.  (f)  How  may  face  presentation  be  converted  into 
vertex  presentation?     (January,  1896.) 

439.  (f)  Hoio  shoidd  labor  be  conducted  in  a  face  presen- 
tation?    {January,  1901.) 

430  to  439.  (a)  King's  Manual  of  Obstetrics,  page  276; 
(b)  page  273;  (c),  (d)  page  281;  (e)  pages  276  to  279;  (f) 
pages  282  and  283;  (g)  page  273;  (h)  page  282. 

440.  Describe  the  difficulties  which  arise  during  labor  from 
mcdposition  of  the  foetal  head. 

440.  King's  Manual  of  Obstetrics,  page  271,  under  prog- 
nosis of  occipito-posterior  positions)  also  pages  280  and  282. 

XV.    MECHANISM  IN  BREECH,  KNEE,  AND  FOOT 
PRESENTATIONS. 

441.  (a)  Describe  briefly  the  usual  mechanism  of  a  breech 
presentation,  and  (b)  state  how  its  dangers  are  to  be  avoided. 
{June,  1902.) 

442.  (c)  Make  a  diagnosis  of  breech  presentation,  and  (b) 
state  the  principles  that  shoidd  govern  its  management.  {June, 
1901.) 

443.  Give  the  (d)  frequency,  (e)  causes,  (c)  diagnosis,  (f) 
prognosis,  (b)  treatment,  and  (f )  dangers  to  the  foetus  in  pelvic 
presentations.     (N'^v^mber,  1893.) 

444.  How  would  you  (c)  diagnose  and  (b)  manage  a  case 
of  breech  presentation?     {May,  1893.) 


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63  OBSTETRICS. 

44^.  (a)  Describe  a  case  of  breech  presentation  and  (b) 
state  how  to  manage  it.     {January,  1895.) 

446.  (c)  Diagnose  breech  presentation,  and  (b)  state  how 
it  should  be  managed.     {May,  1896.) 

44"^'  Give  the  (c)  diagnosis  and  (b)  mano.gement  of  a  case 
of  breech  presentation.     {May,  1897.) 

448-  (c)  Diagnose  and  (b)  stnte  how  to  conduct  a  head- 
last  labor.     {May,  1896.) 

449.  (c)  Make  a  diagnosis  of  an  after-coming  head,  (b) 
giving  in  detail  its  proper  management.    {September,  1899.) 

450.  In  the  case  of  an  after-coming  head,  ivhat  are  the  (c) 
symptoms  and  the  (b)  7nanagementf     {June,  1898.) 

4.51.  Describe  the  (a)  mechanism  and  the  (b)  management 
vf  the  after-coming  head.     {January,  1897.) 

452.  (a)  Describe  the  mechanism  and  (b)  give  the  manage- 
ment of  the  after-coming  head.     {September,  1896.) 

453.  (a)  How  may  the  after-coming  head  be  diagnosed? 
(b)  How  should  such  a  condition  be  managed?  {September, 
1900.) 

454.  (g)  Describe  the  managemeftit  of  an  impacted  breech 
presentation.     {September,  1895.) 

455.  (h)  How  may  the  knee  be  distinguished  from  the 
elbow  when  presenting?     {June,  1898.) 

441  to  455.  (a)  King's  Manual  of  Obstetrics^  pages  288 
et  seq.;  (b)  page  298;  (c)  page  295;  (d)  2  to  4  per  cent,  of  all 
cases;  (e)  King's  Manual  of  Obstetrics,  page  295;  (f)  page 
298;  (g)  pages  306  to  309;  (h)  page  297. 

456.  (a)  What  is  meconium  and  (b)  what  are  its  diagnostic 
relations?     {November,  1893.) 

457.  (a)  What  is  meconium  and  (b)  ivhat  are  its  diagnostic 
relations?     {September,  1892.) 

456  and  457.  (a)  ''The.  stools  of  the  newborn  infant 
are  greenish-black  in  color,  and  are  termed  meconium. 
Meconium  is  composed  of  intestinal  mucus,  bile,  vernix 
caseosa,  epithehal  cells,  hair,  fat,  cholesterin  crystals,  and 
calcium  and  magnesium  phosphates."     (Jewett's  Practice 


64  OBSTETRICS. 

of  Obstetrics.)  (b)  Its  continuous  passage  from  the  vagina 
of  the  parturient  woman  during  labor  indicates  breech 
presentation.  Its  discharge  in  undoubted  head  or  trans- 
verse presentations  is  indicative  of  impending  or  actual 
death  of  the  foetus. 

XVI.    MEOHANISM  IN  TRANSVERSE  PRESENTATIONS. 

438.  (a)  How  may  trunk  presentation  he  recognized  and 
(b)  managed?     (June,  1899.) 

459.  (b)  State  what  must  he  done  to  accomiplish  delivery 
in  a  transverse  or  trunk  presentation.     {May,  1900.) 

460.  (a)  Make  a  diagnosis  of  trunk  presentation  hefore 
rupture  of  the  membranes  and  (b)  indicate  its  management. 
(April,  1897.) 

461 .  (a)  Diagnose  trunk  presentation  before  the  jnembranes 
have  ruptured.     (May,  1896.) 

462.  Give  the  (c)  frequency,  (d)  causes,  (e)  mechanism, 
and  (b)  mayiagement  of  trunk  presentations.     (April,  1894.) 

463.  (b)  Hoio  is  delivery  accomplished  when  the  foetus 
presents  transversely?     (May,  1898.) 

464'  (b)  How  should  a  hand  presentation  be  managed? 
(January,  1896.) 

465.  (a)  Make  a  diagnosis  of  shoulder  presentation,  and 
(b)  state  how  it  should  be  managed.     (June,  1897.) 

466.  (b)  Give  the  management  of  shoulder  presentation  after 
labor  has  begun.     (June,  1896.) 

467.  How  would  you  (a)  diagnose  and  (b)  inanage  a  case 
of  shoulder  presentation?     (January,  1893.) 

468.  How  would  you  (a)  diagnose  and  (b)  manage  a  case 
of  shoulder  presentation?     (September,  1893.) 

469.  (f)  How  should  a  neglected  shoulder  presentation  be 
maiiaged?     (January,  1902.) 

458  to  469.  (a)  King's  Manual  of  Obstetrics,  page  317; 
(b)  pages  320,  312  and  347  et  seq.;  (c)  Once  in  250  cases;  (d) 
King's  Manual  of  Obstetrics,  page  317;  (e)  pages  312  et 
seq.,  including  spontaneous  version  and  evolution;  (f) 
King's  Manual  of  Obstetrics,  page  400. 


65  OBSTETRICS. 

XVII.   DYSTOCIA. 

470.  Define  (a)  eutocia,  (b)  dystocia,  (c),  (d)  Give  an 
example  of  each.     (September,  1900.) 

471.  Define  (a)  eutocia  and  (b)  dystocia,  (c),  (d)  giving 
examples  of  each.     (September,  1899.) 

472.  Define  the  terms  (a)  eutocia,  and  (b)  dystocia,  (d) 
giving  instances  of  the  latter.     (September,  1898.) 

473.  Differentiate  (a)  eutocia  from  (b)  dystocia,  (d) 
Mention  important  varieties  of  the  latter  and  (e)  give  their 
management.     (January,  1899.) 

474'  Differentiate  (a)  eutocia  and  (b)  dystocia^  (d)  Mention 
the  important  varieties  of  dystocia.     (June,  1897.) 

476.  (b)  Define  dystocia  and  (d)  name  its  more  important 
varieties.     {May,  1896.) 

476.  (b)  Define  dystocia  and  (d)  name  its  several  forms. 
(July,  1893.) 

477.  Give  the  (b)  definition  and  (cl)  principal  causes  of 
dystocia.     (March,  1892.) 

478.  (b)  Define  dystocia  and  (e)  give  the  management  of 
some  of  its  most  important  varieties.     (September,  1896.) 

479.  (cl)  Give  the  causes  of  dystocia  in  the  uterus,  vagina, 
pelvis,  and  vuha.     (November,  1893.) 

480.  (d)  Mention  the  causes  of  tedious  labor  and  (e)  state 
the  proper  methods  of  correcting  it.     (May,  1901.) 

481.  (d)  What  are  the  causes  of  delay  in  labor  on  the 
part  of  the  mother,  on  the  part  of  the  child?    (March,  1893.) 

482.  Stctte  the  (f)  dangers  and  the  (g)  symptoms  of  pro- 
longed labor.     (April,  1895.) 

483.  (g)  What  symptoms  presage  tedious  labor,  and  (e) 
whcd  can  be  done  to  accelerate  itf     (November,  1892.) 

484'  (d)  State  the  essential  causes  of  delayed  labor  and 
(e)  show  hoiv  to  overcome  them.     (May,  1898.) 

485.  State  the  (h)  causes  and  (e)  management  of  delayed 
labor  in  the  first  stage.     (June,  1899.) 

470  to  485.  (a)  ''The  term  eutocia  is  applied  to  labors 
which  terminate  without  artificial  aid  and  without  injury 


66  OBSTETRICS. 

to  mother  or  child."  (Jewett's  Practice  of  Obstetrics.)  (b) 
^^  Dystocia  is  the  term  apphecl  to  labor  which,  without 
artificial  assistance,  would  be  difficult  or  impossible,  or 
would  be  attended  with  danger  to  mother  or  child." 
(Jewett's  Practice  of  Obstetrics.)  (c)  e.  g.,  L.  0.  A.  position, 
small   or  medium-sized   child,  roomy  pelvis,  good   pains. 

(d)  '^1.  Anomalies  of  the  expellent  forces:  (a)  excess;  (b) 
deficiency;  (c)  spasm  and  irregularity.  2.  Anomalies  of 
the  passages:  (a)  hard  parts,  pelvic  deformities;  (b)  soft 
parts: — uterus:  developmental  anomalies;  atresia  of  cervix; 
rigidity  of  cervix;  impaction  of  cervix;  malposition;  saccu- 
lation; new-growths;  stenosis  and  rigidity  of  vulva  and 
vagina;  hsematoma  vulvae;  oedema  vulvae;  labial  abscess 
and  cysts;  conditions  of  intestines;  conditions  of  bladder; 
tumors  and  swellings  of  various  tissues.  3.  Anomalies  of 
the  foetus:  malposition  of  head;  occipito-posterior  cases; 
malpresentations,  face,  brow,  pelvic,  transverse;  prolapse 
of  the  limbs;  anomalies  of  foetal  development — shortness 
of  cord,  unduly  ossified  skull,  large  size  of  foetus,  death  of 
foetus,  enlargement  of  head  or  body  by  disease;  plural 
births;  monstrosities."  (Jewett's  Practice  of  Obstetrics.) 
See  also  King's  Manual  of  Obstetrics,  pages  489  et  seq.; 

(e)  pages  495  et  seq.;  (f)  pages  492  and  493;  (g)  pages 
493  and  494;  (h)  pages  490  and  491;  and  add  premature 
rupture  of  membranes. 

486.  (a)  Give  the  treatment  of  dystocia  from  defect  of 
expellent  force  and  (b)  name  the  causes  of  inefficient  pains. 
{June,  1893.) 

487.  (a)  What  medicines  can  be  given  a  woman  in  labor 
to  cause  contractions  of  the  uterus?     {January,  1895.) 

488.  (a)  What  tneans  are  employed  to  stiniidate  iveak 
and  ineffective  uterine  contractions?     {July,  1893.) 

489.  (c)  The  uterine  contractions  being  irregular  during 
labor,  and  the  os  only  slightly  dilated,  ivhat  treatment  should 
be  adopted?     (May,  1894.) 


67  OBSTETRICS. 

490.  (a)  In  ante-partum  uterine  inertia  state  what  should 
he  done  to  stimulate  uterine  contractions.     {April,  1898.) 

491.  Give  the  (cl)  diagnosis  and  (a)  treatment  of  uterine 
inertia.     (September,  1894.) 

492.  (d)  Diagnose  uterine  inertia  and  (a)  give  its  treat- 
ment.    {June,  1896.) 

493.  (b)  What  are  the  principal  causes  of  uterine  inertia 
and  (a)  how  should  it  he  treated?     {May,  1897.) 

494.  (b)  What  are  the  causes  of  uterine  inertia  and  (a) 
how  shoidd  it  he  treated?     {June,  1895.) 

495.  (e)  What  is  meant  hy  inertia  of  the  uterus  during 
lahorf  (f)  How  does  it  complicate  lahor  and  (a)  how  should 
it  he  treated?     {November,  1891.) 

496.  Mention  the  (b)  causes  and  (d)  symptoms  of  uterine 
inertia,  and  (a)  give  the  details  of  management  in  such  cases. 
{January,  1899.) 

497.  (g)  Give  the  causes  of  uterine  inertia  in  the  second 
stage.  How  should  such  a  condition  he  managed?  {Sep- 
temher,  1900.) 

498.  (g)  Give  the  causes  of  delayed  lahor  in  the  second 
stage  and  state  how  they  shoidd  he  overcome.  {Septemher, 
1902.) 

499.  (h)  In  a  lahor  otherwise  normal,  hut  tedious,  how 
soon  is  it  proper  to  interfere  and  lohat  symptoms  woidd 
prompt  such  a  course?     (March,  1892.) 

486  to  499.  (a)  King's  Manual  of  Obstetrics,  pages  495 
et  seq.,  525  and  526;  (b)  pages  490  e^  seq.;  (c)  page  495;  (d) 
pages  493  and  494.  (e)  '^  When  the  uterine  action  is  insuf- 
ficient to  overcome  the  resistance  of  the  parturient  canal 
the  pains  are  said  to  be  lueak.^'  (Jewett's  Practice  of  Ob- 
stetrics.) This  condition  is  inertia  uteri,  (f)  King's  Manual 
of  Obstetrics,  page  492;  (g)  pages  490,  491,  and  495  et 
seq.;  (h)  pages  493  to  495. 

500.  Give  the  diagnosis  and  treatment  of  hour-glass  con- 
tractions of  the  uterus.     (January,  1895.) 

500.  King's  Manual  of  Obstetrics,  pages  491,  496  and 
460. 


68  OBSTETRICS. 

501.  (a)  What  is  meant  by  rigidity  of  the  as  uteri  in  labor 
and  (b)  what  is  its  management?     { September,  1892.) 

502.  (c)  How  may  a  rigid  os  ideri  delaying  labor  be  recog- 
nized, and  (b)  icha.t  shoidd  be  done  in  such  a  case?  (Jan- 
uary, 1898.) 

503.  (b)  Whcd  is  the  proper  management  of  rigidity  of 
the  OS  uteri  in  labor?     (April,  1894.) 

504.  (h)  In  a  case  of  tedious  labor  due  to  undilcded  cervix, 
iQhat  shoidd  be  done?     (April,  1896.) 

501  to  504.  (a),  (b)  King's  Manual  of  Obstetrics,  pages  498 
and  499;  (c)  '^Os  is  sensitive  to  the  touch  and  feels  to  the 
examining  finger  like  a  tensely  stretched  ring;  it  may 
remain  for  hours  michanged,  in  spite  of  strong  uterine 
action.'"'     (Jewett's  Practice  of  Obstetrics.) 

505. ■^( a)  Whcd  would  be  the  effect  of  premature  rupture 
of  the  membranes?     {May,  1894.) 

506.  (a)  What  is  the  significance  of  a  premature  escape 
of  amniotic  fluid?  ,  (b)  Stcde  the  causes.     (January,  1897.) 

507.  (b)  What  are  the  causes  of  premature  rupture  of  the 
me?nbranes  during  labor,  and  fa)  how  does  the  accident 
influence  labor?     (January,  1893.) 

508.  (h)  What  may  cause  premcdure  rupture  of  the  mem- 
branes? How  may  this  rupture  influence  (a)  the  progress 
and  (q)  conduct  of  labor?     (June,  1899.) 

509.  (h)  What  are  the  causes  of  premature  rupture  of 
the  membranes  in  labor,  and  how  does  this  accident  influence 
the  (a)  course  and  (o)  conduct  of  labor?     (January,  1894.) 

510.  (b)  Mention  the  causes  of  premature  rupture  of  the 
membranes  in  Ictbor,  and  .state  how  this  accident  may  influence 
the  fa)  course  and  (o)  conduct  of  labor.     (June,  1897.) 

505  to  510.  (a)  By  robbing  the  uterus  of  its  dilating 
wedge,  it  minimizes  the  effect  of  the  contractions,  retard- 
ing cervical  dilatation,  predisposing  to  spasm  of  the  os 
with  secondary  uterine  inertia  and  its  sequels,  or,  on  the 
other  hand,  tojiic  contraction  of  the  uterus.  Also,  by 
permitting  the  premature  escape  of  the  liciuor  amnii,  it 


69  OBSTETRICS. 

removes  the  hydrostatic  element  from  the  mechanism 
of  expulsion,  and  nullifies  the  action  of  all  but  the  longi- 
tudinal muscular  fibres  of  the  uterus,  (b)  1.  Abnoniial 
thinness.  2.  Irregular  adhesions  to  uterine  mucosa.  3. 
Separation  of  the  two  laj^ers  of  membrane,  with  distention 
by  fluid  of  the  space  between.  4.  Smallness,  irregular 
shape,  or  hindered  descent  of  the  presentmg  part.  5. 
Excessively  strong  contractions  at  the  onset  of  labor. 
6.  Rough  vaginal  examinations,  (c)  King's  Manual  of 
Obstetrics,  page  499. 

511.  (a)  What  obstructions  of  the  soft  parts  prevent  an 
otherwise  normal  delivery?     {March,  1892.) 

512.  (b)  What  forms  of  tumors  may  complicate  labor, 
and  how?     {March,  1892.) 

511  and  512.  (a)  King's  Manual  of  Obstetrics,  pages  503 
et  seq.;  (b)  pages  507  et  seq. 

513.  What  obstructions  in  the  ^yiaternal  parts  may  retard 
the  progress  of  labor,  and  what  treatment  is  indicated  to  over- 
come each?     {May,  1895.) 

514.  Mention  some  of  the  anomalies  of  the  maternal  soft 
structures  that  may  serve  to  obstruct  labor,  and  state  what 
should  be  done  in  each  condition  inentioned.  {September, 
1902.) 

513  and  514.  Kmg's  Manual  of  Obstetrics,  page  498  et  seq. 

515.  What  are  rectocele  and  cystocele  and  how  do  they 
complicate  labor?     {January,  1893.) 

516.  Give  a  description  of  cystocele  and  rectocele.  State 
how  each  may  complicate  labor,  and  what  should  be  done  in 
the  arising  contingency.     {May,  1899.) 

517.  Give  a  brief  pathological  definition  of  rectocele  and 
cystocele.  State  Jww  they  may  complicate  labor,  and  lohat 
shoidd  be  done  in  su^h  cases.     {April,  1898.) 

515  to  517.  King's  Manual  of  Obstetrics,  page  505. 

618.  What  can  be  done  to  modify  the  dangers  of  labor 


70  OBSTETRICS. 

when  complicated  by  the  presence  of  an  ovarian,  fibroid^  or 
polypoid  tumor?     (jtrne,  1892.) 

518.  King's  Manual  of  Obstetrics,  pages  507  to  511. 

519.  (a)   Give  a  pathological  definition  of  hydrocephalus. 

(b)  State  how  it  may  he  diagnosed,  and  (c)  give  the  com- 
plications it  may  cause  in  the  management  of  labor.  {May, 
1897.) 

520.  (a)  Define  hydrocephalus,  (d)  State  hoiv  hydro- 
cephalus may  complicate  labor,  and  (c)  lohat  should  be  done 
in  such  a  case.     (January,  1898.) 

521.  (a)  What  is  hydrocephalus?  (b)  How  ivoidd  you 
diagnose  its  presence  in  the  foetus,  and  (c)  hoiv  does  its  ex- 
istence complicate  the  management  of  labor?    {April,  1893.) 

522.  (a)  What  is  the  pathology  of  hydrocephalus?  How 
may  hydrocephalus  be  (b)  recognized  and  (c)  treated?  {June, 
1899.) 

523.  (a)  Give  the  pathology  of  hydrocephalus.  State  (b) 
hoio  hydrocephalus  may  be  recognized  before  delivery,  and 

(c)  hoiv  such  a  comjMcation  should  be  dealt  with.  {Sep- 
tember, 1900.) 

519  to  523.  (a)  King's  Manual  of  Obstetrics,  page  484. 
Note :  The  fluid  collects  principally  in  the  lateral  ventricles, 
(b)  Kmg's  Manual  of  Obstetrics,  page  485;  (c)  page  486; 

(d)  page  486  (Prognosis). 

524.  How  may  a  short  funis  complicate  labor?  State 
how  such  a  condition  shoidd  be  managed.    {September,  1902.) 

524.  King's  Manual  of  Obstetrics,  pages  520  and  521. 

525.  (a)  Define  multiple  pregnancy,  (b)  Make  a  diag- 
nosis of  this  condition.     {May,  1901.) 

526.  (b)  How  can  the  presence  of  more  than  one  foetus 
in  utero  be  ascertained  before  labor  has  commenced?  {April, 
1895.) 

527.  (b)  Make  a  diagnosis  of  multiple  pregnancy  at  or 
about  the  thirty-fifth  week  as  determined  by  external  {non- 
bimanual)  palpation.     {April,  1897.) 


71  OBSTETRICS. 

528.  (b)  Make  a  diagnosis  of  multij)le  pregnancy  after 
the  thirty-fifth  lueek,  and  (d)  state  how  delivery  may  he  com- 
plicated thereby.     (January,  1898.) 

529.  (d)  What  is  the  ordinary  course  of  twin  labor,  and 
what  are  the  difficulties  likely  to  occur?     (July,  1893.) 

530.  (b)  Diagnose  a  twin  labor,  (d)  State  what  com- 
plications may  arise  in  it,  and  (c)  show  how  they  may  be 
overcome.     {May,  1897.) 

531.  (b)  How  may  midtiple  pregnancy  be  recognized? 
(d)  State  how  it  may  complicate  labor,  and  (c)  show  how 
labor  should  be  managed  when  this  condition  exists.  {Jan- 
uary, 1900.) 

632.  (b)  How  may  a  twin  labor  be  recognized?  (d)  What 
complications  may  arise  during  its  course,  and  (c)  how 
should  such  complications  be  managed?     {May,  1899.) 

533.  (d)  What  complications  may  arise  in  a  tvnn  labor, 
and  (c)  how  may  they  be  overcome?     {September,  1896.) 

534.  (c)  What  peculiar  management  is  required  in  twin 
pregnancy?     {March,  1892.) 

525  to  534.  (a)  King's  Manual  of  Obstetrics,  page  477; 
(b)  page  479;  (c)  page  481;  (d)  page  480. 

535.  What  is  super fcetation,  and  how  does  it  take  place? 
{September,  1896.) 

535.  King's  Manual  of  Obstetrics,  page  589,  ^' Third." 

536.  What  are  the  dangers  of  precipitate  labor,  and  how 
may  they  be  averted?     {September,  1898.) 

537.  What  are  the  dangers  of  too  rapid  labor,  and  how 
can  such  dangers  be  modified?     {June,  1892.) 

536  and  537.  King's  Manual  of  Obstetrics,  pages  497 
and  498. 

XVIII.    DEFORMED  PELVIS  AND  PELVIMETRY. 

538.  What  are  the  varieties  of  deformed  pelvis?  {April, 
1895.) 

539.  Name  the  deformities  of  the  female  pelvis  and  their 
causes.     {November,  1892.) 


72  OBSTETRICS. 

540.  What  varieties  of  the  deformed  pelvis  are  liable  to 
interfere  with  obstetrical  procedure?     How?     {June,  1894.) 

54I'  What  difficulties  arise  during  labor  from  malfor- 
mations of  the  maternal  pelvis?     (November,  1892.) 

538  to  541.  King's  Manual  of  Obstetrics,  pages  402 
to  414. 

542.  Describe  (a)  justo-minor  pelvis  and  (b)  justo-major 
pelvis,  (c),  (d)  Rtate  how  each  may  influence  or  complicate 
labor.     {April,  1897.) 

64s.  Describe  (a)  justo-minor  pelvis  and  (b)  justo-major 
pelvis,  (c);  (d)  State  how  each  may  influence  the  course  of 
labor.     {April,  1898.) 

544'  Describe  and  differentiate  (a)  justo-minor  and  (b) 
justo-major,  pelvis  and  (c),  (d)  state  how  each  may  complicate 
labor.     {January,  1900.) 

545.  Describe  and  differentiate  (a)  justo-minor  pelvis 
and  (b)  justo-major  pelvis,  (c),  (d)  State  how  each  may 
complicate  labor.     {September,  1900.) 

646.  Describe  the  (b)  justo-major  and  the  (a)  justo-minor 
pelvis,  and  (c),  (d)  state  how  each  may  influence  labor  and 
delivery.     {May,  1901.) 

542  to  546.  (a)  King's  Manual  of  Obstetrics,  page  404; 
(b)  page  403;  (c)  pages  404  and  424;  (d)  page  404. 

547.  (a)  Describe  pelvimetry  and  (b)  state  its  obstetrical 
uses  and  value.     {September,  1901.) 

548.  (c)  Define  pelvimetry  and  (b)  state  its  object,  (a) 
Show  how  pelvimetry  is  accomplished.     {May,  1902.) 

547  and  548.  (a)  King's  Manual  of  Obstetrics,  pages  417 
et  seq.;  (b)  pages  402  to  431 ;  (c)  Measurement  of  the  pelvic 
dimensions. 

XIX.   PROLAPSE  OF  FUNIS. 

549.  (a)  What  is  meant  by  prolapse  of  the  funis?  (b) 
When  does  it  occur?  (c)  What  are  its  dangers?  (d)  How 
would  you  manage  such  a  case?     {September,  1893.) 


74  OBSTETRICS. 

564.  (c)  Give  the  treatment  of  recent  inversion  of  the 
uterus.     {November,  1892.) 

560  to  564.  (a)  King's  Manual  of  Obstetrics,  page  463; 
(b)  page  464;  (c)  page  465. 

XXI.  RUPTURE  OF  THE  UTERUS. 

565.  (a)  How  may  rupture  of  the  uterus  during  labor  be 
recognized?  (b)  What  shoidd  be  done  in  case  of  such  a 
rupture?     {January,  1901.) 

566.  (a)  Describe  the  symptoms  of  rupture  of  the  uterus 
during  labor.     {September,  1892.) 

567.  (a)  Describe  the  symptoms  and  (b)  give  the  treatment 
of  rupture  of  the  uterus.     {April,  1895.) 

568.  What  are  the  (c)  causes,  (a)  symptoms,  and  (b) 
treatment  of  rupture  of  the  uterus?     {June,  1896.) 

569.  What  are  the  (c)  causes,  (a)  symptoms,  and  (b) 
treatment  of  rupture  of  the  uterus?     {January,  1898.) 

570.  Give  the  (c)  causes,  (a)  symptoms,  diagnosis,  (d) 
prognosis,  and  (b)  treatment  of  rupture  of  the  uterus.  {April, 
1899.) 

571.  Describe  the  (a)  symptoms  of  rupture  of  the  uterus 
during  labor.     {September,  1893.) 

572.  Give  the  (c)  causes,  (a)  symptoms,  and  (b)  manage- 
ment of  rupture  of  the  uterus  during  labor.  {September, 
1901.) 

573.  Give  the  (a)  symptoms  of  rupture  of  the  uterus  during 
labor  and  (b)  state  how  such  an  accident  should  be  managed. 
{May,  1897.) 

574.  (a)  What  symptoms  lead  to  the  suspicion  of  rupture 
of  the  uterus  during  labor?  (b)  State  how  such  a  compli- 
cation should  be  managed.     {May,  1898.) 

575.  (a)  How  may  rupture  of  the  uterus  during  labor  be 
recognized?     (b)  How  should  it  be  managed?     {June,  1899.) 

576.  (b)  HoiD  would  you  manage  a  case  of  rupture  of 
the  uterus  during  labor?     {January,  1893.) 


75  OBSTETRICS. 

577.  (b)  HoiD  should  a  case  of  rupture  of  the  uterus  during 
labor  be  managed?     {June,  189 4-) 

565  to  577.  (a)  King's  Manual  of  Obstetrics,  page  467; 
(b)  pages  470  et  seq.;  (c)  page  466;  (d)  page  470. 

578.  Give  the  causes  and  treatment  of  laceration  of  the 
cervix  uteri.     {June,  1896.) 

578.  King's  Manual  of  Obstetrics,  page  473. 

XXII.    PLACENTA  PR-ffiVIA;  RETAINED  PLACENTA;  THE 

HEMORRHAGES. 

579.  Give  the  (a)  definition  and  pathology  of  placenta 
prcEvia.  (b)  State  how  placenta  prcevia  should  be  managed. 
{January,  1900.) 

580.  (a)  Describe  the  varieties  of  placenta  prcevia.  {Aprilj 
1896.) 

581.  (a)  Mention  the  varieties  of  placenta  prcevia  and 
make  a  differential  diagnosis  of  the  varieties.  {September j 
1898.) 

582.  (c)  Make  a  diagnosis  of  placenta  prcevia  and  (b) 
state  hoio  such  a  condition  should  be  managed.    {May,  1900.) 

583.  Give  the  (d)  causes,  (a)  varieties,  (c)  symptoms, 
and  (b)  management  of  placenta  prcevia.     {September,  1896.) 

584.  Give  the  (d)  causes,  (c)  symptoms,  and  (b)  manage- 
ment of  placenta  prcevia.     {September,  1902.) 

585.  (a)  Mention  the  varieties  of  placenta  prcevia,  and 
(b)  state  how  each  should  be  managed.     {April,  1897.) 

586.  (a)  Name  the  varieties  of  placenta  prcevia,  and  (b) 
give  the  management  of  each.     {September,  1896.) 

587.  (a)  Describe  the  varieties  of  placenta  prcevia,  and 
(b)  give  the  treatment  of  each  variety.     {September,  1901.) 

588.  (a)  Define  and  classify  placenta  prcevia,  and  (b) 
state  how  it  shoidd  be  dealt  with.     {June,  1898.) 

589.  (a)  Name  the  varieties  of  placenta  prcevia,  and  (b) 
state  hoio  they  should  be  managed.     {June,  1895.) 


76  OBSTETRICS. 

590.  (a)  What  is  placenta  prceviaf  Name  its  (d)  causes, 
(c)  symptoms,  and  (b)  management.     {November,  1894.) 

591.  (c)  What  is  the  characteristic  symptom  of  placenta 
prceviaf     {April,  1893.) 

592.  (b)  How  should  a  case  of  placenta  prcevia  centralis 
be  treated?     (January,  1894.) 

593.  (b)  What  is  the  treatment  of  placenta  prceviaf  {Jan- 
uary, 1893.) 

594'  (b)  How  would  you  manage  a  case  of  placenta  prceviaf 
{January,  1892.) 

579  to  594.  (a)  King's  Manual  of  Obstetrics,  page  443; 
(b)  page  445;  (c)  page  444;  (cl)  page  443. 

595.  (a)  State  the  causes  and  (b)  give  the  proper  manage- 
ment of  retained  placenta  after  normcd  labor.     (June,  1900.) 

596.  Describe  the  (a)  causes  of  retained  placenta  and  the 
(b)  proper  management  of  its  varieties.     {April,  1894.) 

597.  (a)  What  are  the  causes  of  retained  placenta?  (b) 
Give  the  treatment  for  each  variety.     (September,  1896.) 

598.  (c)  Hoiu  should  the  placenta  be  delivered  at  term? 
(b)  What  is  the  managemeiit  of  retained  placenta?  {May, 
1895.) 

599.  (b)  Give  the  technique  of  manual  removal  of  the 
placenta.     (May,  1901.) 

600.  (b)  Describe  the  proper  method  of  delivering  an 
adherent  placenta  at  term.     {September,  1900.) 

601.  (b)  Hoio  should  adherent  placenta  be  treated?  {No- 
vember, 1893.) 

602.  (b)  Describe  the  management  in  detail  in  case  of 
adherent  placenta  after  delivery  of  the  fcetus  at  term.  {June, 
1899.) 

595  to  602.  fa)  King's  Manual  of  Obstetrics,  page  460; 
(b)  page  460;  (c)  See  above,  Q.  315  to  326,  (a). 

603.  Mention  the  varieties  of  hemorrhage  that  mciy  affect 
the  pregnant  woman,  the  parturient  woman,  and  the  puerperal 
woynan.-  Explain  the  causes  and  describe  the  treatment  of 
each  variety.     {January,  1902.) 


77  OBSTETRICS. 

603.  King's  Manual  of  Obstetrics,  pages  443,  449,  450 
and  459. 

604.  Describe  three  important  forms  of  hemorrhage  occur- 
ring in  obstetrical  practice.     (September,  1895.) 

604.  King's  Manual  of  Obstetrics,  pages  443,  449  and 
450. 

605.  (a)  How  would  you  manage  a  case  of  uterine  hemor- 
rhage prior  to  labor?     {June,  1892.) 

606.  Give  the  (b)  causes,  (c)  import,  and  (a)  management 
of  ante-partum  hemorrhage.     {September,  1897.) 

607.  What  are  the  (b)  causes  and  (c)  import  of  hemor- 
rhage before  labor,  and  (a)  how  would  you  manage  such  a 
case?     {January,  1894-.) 

608.  What  are  the  (b)  causes  and  (c)  import  of  hemor- 
rhage before  labor?     {January,  1893.) 

609.  State  (b)  the  causes  of  ante-partum  hemorrhage,  and 
(a)  mention  the  measures  that  should  be  taken  to  restrain  it. 
{May,  1901.) 

605  to  609.  (a)  First  diagnose  between  accidental  hemor- 
rhage and  that  due  to  placenta  prsevia.  For  treatment 
appropriate  to  each,  see  King's  Manual  of  Obstetrics, 
pages  445  and  450.  (b)  Placenta  prsevia;  partial  separa- 
tion of  normally  implanted  placenta.  See  King's  Manual 
of  Obstetrics,  pages  443  and  449;  (c)  pages  443,  third 
paragraph;  449,  last  paragraph. 

610.  What  is  meant  by  concealed  hemorrhage?  State  its 
cause  and  management.     {June,  1892.) 

610.  Hemorrhage  from  the  placental  site,  which,  failing 
to  find  an  outlet,  accumulates  within  the  uterine  cavity. 
See  King's  Manual  of  Obstetrics,  pages  449  and  450. 

611.  Make  a  differential  diagnosis  of  intra-uterine  hemor- 
rhage and  extra-uterine  hemorrhage.     {April,  1899.) 

611.  King's  Manual  of  Obstetrics,  page  185,  '^symp- 
toms of  rupture,"  and  page  449,  third  paragraph. 


9- 


78  OBSTETRICS. 

612.  (a),  (c)  What  conditions  and  sy7nptoms,  both  during 
and  after  labor,  would  lead  you  to  apprehend  post-partum 
hemorrhage?     (March,  1893.) 

613.  (a)  Mention  the  principal  causes  of  post-partum 
hemorrhage,  and  (b)  state  the  details  of  prevention  and  of 
management.     {January,  1899.) 

614'  G'^^^^  ihe  (a)  causes,  (c)  symptoms,  and  (b)  treatment 
of  hemorrhage  occurring  during  the  third  stage  of  labor. 
{September,  1896.) 

615.  (a)  Name  the  causes  of  post-partum  hemorrhage, 
and  (b)  give  the  details  of  its  management.    {September,  1896.) 

616.  (a)  Give  the  usual  causes  of  post-partum  hemorrhage, 
and  (b)  state  the  principles  of  its  management.    (May,  1897.) 

617.  (a)  State  the  principcd  causes  of  post-partum  hemor- 
rhage, and  (b)  give  its  management.     {January,  1897.) 

618.  (c)  What  are  the  usual  symptoms  of  post-partum 
hemorrhage?  (b)  How  should  post-partum  hemorrhage  be 
treated?     {September,  1898.) 

619.  Describe  post-partum  hemorrhage,  naming  its  (c) 
symptoms  and  (a)  causes.     {June,  1896.) 

620.  (a)  Name  the  causes  of  post-partum  hemorrhage  ante- 
cedent to  labor  and  subsequent  to  labor.     {November,  1893.) 

621.  (b)  How  ivould  you  treat  a  case  of  post-partum 
hemorrhage?     (April,  1893.) 

622.  Give  the  (a)  chief  cause  and  (b)  management  of 
post-partum  hemorrhage?     (January,  1892.) 

623.  (a)  What  are  the  causes  of  hemorrhage  after  labor, 
and  (b)  what  is  the  treatment?     (November,  1891.) 

624-.  (a)  State  the  causes  and  ((b)  give  the  treatment  of 
post-partum  hemorrhage.     (September,  1894.) 

625.  Name  the  causes  of  post-partum  hemorrhage,  and 
(b)  give  the  details  of  its  management.     (June,  1895.) 

626.  (b)  What  is  the  treatment  of  post-partum  hemorrhage, 
preventive  and  curative?     (April,  1895.) 

627.  (d)  What  are  after-pains?  (a)  Give  the  causes  of 
post-partum  hemorrhage.     (April,  1899.) 


79  OBSTETRICS. 

612  to  627.  (a)  King's  Manual  of  Obstetrics^  page  451; 
(b)  pages  452  et  seq.;  (c)  page  452;  (d)  page  247. 

628.  (a)  What  is  ergot,  (b)  what  are  its  most  reliable 
forms;  (c)  when  and  in  what  dose  is  it  properly  and  im- 
properly employed? 

629.  (c)  Mention  the  indications  for  the  use  of  ergot  in 
labor,  fb),  (c)  How  shoidd  ergot  be  employed?  (September, 
1902.) 

628  and  629.  (a)  The  sclerotium  of  Glaviceps  purpurea, 
a  fungus  growing  on  rye.  (b)  Fluid  extract,  J  to  2  drachms; 
ergotole  (half  the  dose  of  fluid  extract);  ergotin  f  to  5 
grains.  The  two  latter  only  should  be  used  hypodermic- 
ally,  as  the  fluid  extract  irritates,  (c)  King's  Manual  of 
Obstetrics,  page  525. 

XXIII.   ECLAMPSIA. 

630.  (e)  Define  puerperal  eclampsia.  Give  the  (a)  causes, 
(f)  pathology,  and  (d)  treatment  of  puerperal  eclampsia. 
(January,  1901.) 

631.  (e)  Define  puerperal  eclampsia.  Give  the  (a)  causes 
and  (d)  treatment  of  puerperal  eclampsia.  (September, 
1902.) 

632.  (e)  Define  puerperal  eclampsia,  and  give  its  (a) 
etiology,  (g)  prognosis,  and  (d)  treatment.     (May,  1897.) 

633.  (e)  Define  puerperal  eclampsia  and  give  its  (a) 
etiology,  (g)  prognosis,  and  (cl)  treatment.     (January,  1899.) 

634.  Describe  the  (f)  nature,  (a)  causes,  and  (d)  treatment 
of  puerperal  eclampsia.     (June,  1901.) 

635.  Give  the  (h)  danger  signals  of  impending  eclampsia. 
(May,  1901.) 

636.  (d)  In  case  eclampsia  gravidarum  appears  before 
the  end  of  the  eighth  month,  how  should  it  be  managed? 
(May,  1899.) 

637.  State  the  (a)  causes,  (b)  symptoms,  and  (d)  treat- 
ment of  eclampsia  gravidarum.     (January,  1898.) 


80  OBSTETRICS. 

638.  Give  the  (a)  theory  of  causation,  (d)  treatment,  mid 
(g)  prognosis  of  eclampsia  gravidarum.     (November,  1893.) 

639.  Give  the  (f )  pathology  and  (h)  prodromata  of  eclampsia 
gravidarum,  and  (i)  state  the  relative  frequency  in  primiparce 
and  jnultiparcB.     {November,  189 4.) 

6Jf.O.  (d)  Describe  the  treatment  of  eclampsia.    {July,  1893.) 
6Jf.t.  Give  the  (b)  symptoms  and  (d)  treatment  of  puerperal 
convulsions.     {June,  1892.) 

642.  (a)  State  the  causes  of  the  different  varieties  of  puer- 
peral convulsions.     {March,  1892.) 

643.  (j)  What  are  the  varieties  of  puerperal  convulsions, 
and  how  are  they  differentially  diagnosed?     {January,  1892.) 

6Jf4'  Puerperal  eclampsia,  give  (a)  causes;  (b)  symptoms; 
(c)  preventive  management;  (d)  treatment.     {March,  1893.) 

645.  (e)  Define  puerperal  eclampsia  and  give  its  (a) 
etiology,  (g)  prognosis,  and  (d)  treatment.    {September,  1896.) 

64.6.  (b)  Diagnose  urcemic  eclampsia,  and  (d)  give  the 
treatment.     (April,  1896.) 

647.  (b)  Diagnose  an  eclamptic  seizure,  and  (g)  give  the 
prognosis  of  the  disease.     (June,  1895.) 

648.  (b)  Describe  an  eclamptic  seizure  in  the  puerperal 
condition,  and  (d)  outline  the  treatinent.     (September,  1896.) 

630  to  648.  (a)  King's  Manual  of  Obstetrics,  page  526. 
Predisposing  causes:  1.  All  chronic  and  acute  forms  of 
kidney  disease.  2.  Long-continued  and  marked  retention 
of  urine,  particularly  that  produced  by  pressure  on  the 
ureters  by  (a)  abnormally  enlarged  uterus,  twin  preg- 
nancy, hydramnios;  (b)  small  pelvis;  (c)  large  foetus  or 
foetal  head.  3.  Very  young  or  very  old  primiparse,  on 
account  of  rigidit}^  and  lack  of  room  in  their  pelvic  and 
abdominal  cavities.  Exciting  causes:  1.  Sudden,  partial 
or  complete,  suppression  of  urine.  2.  Constipation.  3. 
Painful  uterine  contractions.  4.  Prolonged  and  exhausting 
efforts  at  expulsion.  5.  Profound  emotion."  (Jewett's 
Practice  of  Obstetrics.)  (b)  King's  Manual  of  Obstetrics, 
page  527;    (c)  pages  146  (last  hne)  to  149;    (d)  page  528. 


(( 


81  OBSTETRICS. 

(e)  ''An  acute  morbid  condition^  making  its  advent  dm^ing 
pregnancy,  labor,  or  the  puerperal  state,  which  is  charac- 
terized by  a  series  of  tonic  and  clonic  convulsions,  affecting 
first  the  voluntary  and  then  the  involuntary  muscles,  accom- 
panied by  complete  loss  of  consciousness  and  ending  in 
coma  or  sleep/^  (Jewett's  Practice  of  Obstetrics.)  (f) 
^'Post-mortem  changes:  an  anaemia  of  the  organs  generally, 
a  congestion  of  the  cerebral  cortex,  occasional  slight  hepatic 
apoplexies,  and  a  fluid  condition  of  the  blood.  The  chief 
changes,  diminished  urinary  toxicity  and  corresponding  in- 
crease in  amount  of  circulatory  poisons,  are  rather  to  be 
found  intra  vitam  than  after  cleath/'  (Jewett's  Practice 
of  Obstetrics.)  (g)  King's  Manual  of  Obstetrics,  page  528; 
(h)  pages  528  and  146.  (i)  ''The  proportion  of  eclamptic 
primiparse  to  multiparse  is  three  to  one."  (Jewett's 
Practice  of  Obstetrics.)  (j)  King's  Manual  of  Obstetrics, 
page  527. 

XXIV.   OBSTETRIC  SURGERY. 

1.  Induction  of  Premature  Labor. 

649.  (a)  Classify  abortion,  miscarriage,  and  premature 
labor;  state  (b)  when  their  induction  is  justifiable,  and  (c) 
how  they  are  performed.     {May,  1894.) 

650.  (a)  What  is  abortion?  (b)  When  and  (c)  how  shoidd 
it  be  induced?     {April,  1895.) 

651.  (b)  When  is  it  justifiable  to  produce  an  abortion? 
{May,  1893.) 

652.  (b)  What  conditions  justify  the  induction  of  abortion? 
(c)  Mention  the  methods  that  may  be  employed.    {June,  1901.) 

653.  (c)  Hdio  can  premature  labor  be  most  safely  induced, 
and  how  would  you  conduct  a  case  of  that  kind?  {November, 
1892.) 

654.  (b)  Is  the  induction  of  premature  labor  ever  justifiable, 
and,  if  so,  when?     {April,  1893.) 

655.  (b)  Is  the  production  of  premature  labor  ever  justifi- 


82  OBSTETRICS. 

able?    If  so,  when  and  (c)  how  would  you  accomplish  that 
object?     {November,  1893.) 

656.  (b)  When  is  the  induction  of  premature  labor  justi- 
fiable, and  (c)  how  inay  premature  labor  be  induced?  {Jan- 
uary, 1896.) 

657.  (b)  Under  ivhat  conditions  should  a  premature  labor 
be  induced?     {June,  1894.) 

658.  (b)  Under  what  circumstances  is  premature  delivery 
demanded?  (c)  How  should  premature  delivery  be  induced? 
{June,  1902.) 

659.  (b)  Under  what  conditions  is  the  induction  of  pre- 
mature labor  justifiable,  and  (c)  how  should  it  be  perforined? 
{May,  1898.) 

660.  (b)  What  conditions  justify  the  induction  of  prema- 
ture loJjor  during  viability  of  the  foetus?    (January,  1897.) 

661.  (b)  What  are  the  indications  for  the  induction  of 
premature  labor  after  the  beginning  of  the  eighth  month? 
{June,  1898.) 

662.  (b)  Under  what  conditions  may  the  ^induction  of 
premature  labor  {child  viable)  become  justifiable,  and  (c) 
how  should  it  be  performed?     {May,  1900.) 

663.  (a)  What  is  premature  labor,  and  (b)  when  and  (c) 
how  should  it  be  induced,  the  foetus  being  viable?  {June, 
1896.) 

66Jf..  (b)  Under  what  conditions  may  the  induction  of 
premature  labor  {child  viable)  become  justifiable,  and  (c) 
how  should  it  be  performed?     {May,  1899.) 

665.  (b)  Give  the  indications  for  the  induction  of  premature 
labor  {child  viable),  and  (c)  state  how  it  shoidd  be  performed. 
{September,  1901.) 

666.  (b)  What  circumstances  justify  the  induction  of 
premature  labor  (foetus  viable),  and  (c)  lohat  means  are  best 
to  promote  it?     {September,  1897.) 

667.  Give  the  (a)  definition,  (d)  causes,  (e)  diagnosis, 
and  (f)  treatment  of  premature  labor;  and  also  (b)  indi- 
cations for  its  induction.     (June,  1893.) 


83  OBSTETRICS. 

649  to  667.  (a)  King's  Manual  of  Obstetrics,  page  171; 
(b)  page  432;  (c)  pages  435  et  seq.  and  434;  (d)  page  172; 
(e)  page  173;  (f)  page  182,  see  also  pages  176  et  seq. 

2.  Forceps. 

668.  (a)  Describe  the  common  varieties  of  obstetric  forceps 
and  their  adaptations.     (November,  1894.) 

669.  Describe  (a)  the  common  varieties  of  obstetric  forceps 
and  (b)  their  application.     {November,  1891.) 

670.  (c)  What  powers  may  be  exerted  by  the  forceps?  (b) 
Describe  its  application.     {April,  1895.) 

671.  (d)  What  are  the  indications  for  the  use  of  forceps? 
{March,  1892.) 

672.  (b)  Describe  the  position  of  patient  and  physician 
for  the  readiest  and  safest  means  of  applying  the  forceps. 
{May,  1894.) 

673.  (d)  What  conditions  justify  the  use  of  forceps,  and 
(b)  what  preliminaries  are  necessary  to  its  application? 
{September,  1895.) 

674'  (d)  State  the  important  indications  for  using  the 
forceps,  (b)  Explain  the  amplication  of  the  forceps,  giving 
necessary  preparations.     {May,  1898.) 

675.  (d)  Give  indications  for  the  employment  of  forceps, 
and  (b)  state  rules  and  precautions  to  be  observed.  {June, 
1897.) 

676.  (d)  When  may  .  the  forceps  become  advisable?  (b) 
How  should  they  be  applied  and  what  cautions  should  be 
observed  in  their  application?     {May,  1899.) 

677.  (b)  What  general  rides  should  be  observed  in  using 
the  forceps?     {June,  1895.) 

678.  (d)  Under  what  conditions  should  the  forceps  be 
employed?  (b)  How  should  the  instrument  be  used?  {Jan- 
uary, 1901.) 

679.  (e)  Describe  the  use  of  the  forceps  in  the  occipito- 
posterior  position.     {January,  1896.) 


84  OBSTETRICS. 

680.  (f)  Make  a  diagnosis  of  face  presentation.' .^  (g) 
How  should  forceps  he  applied  in  a  case  of  face  presentation? 
{January,  1898.) 

681.  (d)  Describe  the  occasion  for  the  application  of  the 
forceps  in  the  inferior  strait.     {November,  1893.) 

682.  Give  the  (h)  etymology  and  (c)  uses  of  the  forceps, 
and  (h),  (cl)  ncmie  the  conditions  for  its  application,  together 
with  the  rides  therefor  and  precautions  to  be  observed  in 
the  same.     {June,  1893.) 

■  668  to  682.  (a)  ^^The  modern  obstetric  forceps  consists  of 
two  interlocking  arms  or  branches.  Each  has  fom*  parts — 
handle^  lock,  shank,  and  blade.  The  handles  when  the  arms 
are  locked  fall  together  so  as  to  be  both  conveniently 
grasped  by  one  hand  of  the  operator.  For  a  more  secure 
hold  they  are  generally  roughened  or  corrugated  on  their 
outer  margins.  There  is  usualty  a  transverse  projection 
at  the  upper  end  of  each  handle  over  which  a  finger  may 
be  hooked  when  making  traction.  The  blades  in  the 
prevailing  patterns  of  forceps  have  a  double  curve — a 
cephalic  and  a  pelvic.  The  former  adapts  them  to  the 
shape  of  the  foetal  head,  the  latter  to  that  of  the  birth- 
canal.  The  cephalic  curve  is  elliptical  rather  then  circular, 
since  the  former  better  adapts  itself  to  heads  of  different 
sizes.  In  the  usual  pattern  the  cephalic  and  the  pelvic 
curves  are  nearly  ec{ual.  The  shanks  connect  the  blades  and 
the  handles.  The  lock  is  based  either  on  the  Smellie  or  on 
the  Levret  model.  The  former  is  constructed  on  the  prin- 
ciple of  a  mortise  and  tenon;  in  the  latter  there  is  on  the 
lower  half  a  thumbscrew,  or  a  pin  surmounted  by  a  button, 
and  in  the  edge  of  the  other  half  a  notch  into  which  the 
pin  or  screw  fits.  The  lock  is  usually  placed  one-third 
way  from  the  proximal  to  the  distal  end  of  the  instrument.''' 
(Abridged  from  Jewett's  Practice  of  Obstetrics.)  And  see 
King's  Manual  of  Obstetrics,  pages  324,  322,  323,  336,  337, 
339,  340  and  341.  (b)  pages  325  et  seq.;  (c)  pages  324, 
''action   of   forceps;"  and  332.      (d)   ''1.  Forces  at  faidt: 


85  OBSTETRICS. 

Inertia  uteri  in  the  presence  of  conditions  likely  to  jeopar- 
dize the  interests  of  mother  or  child,  (a)  Impending  ex- 
haustion; (b)  arrest  of  head,  from  feeble  pains.  2.  Passages 
at  fault:  Moderate  narrowing  3^-  to  3|  inches,  true  conju- 
gate; moderate  obstruction  in  the  soft  parts.  3.  Passenger 
at  fault:  A.  Dystocia  due  to  (a)  occipito-posterior ;  (6) 
mento-anterior  face;  (c)  breech  arrested  in  cavity.  B. 
Evidence  of  foetal  exhaustion  (pulse  above  160  or  below 
100  per  minute).  4.  Accidental  complications:  Hemor- 
rhage; prolapsus  funis;  eclampsia.  AH  acute  or  chronic 
diseases  or  complications  in  which  immediate  delivery  is 
required  in  the  interest  of  mother  or  child  or  both." 
(Abridged  from  Jewett's  Practice  of  Obstetrics.)  (e)  King's 
Manual  of  Obstetrics,  page  332,  last  paragraph;  (f)  page 
281;  (g)  page  344;  (h)  the  Latin  word  forceps  =  Si  pair  of 
tongs. 

683.  Describe  the  (a)  high  and  (b)  loiu  forceps  operations 
respectively,  mentioning  the  instruments  appropriate  to  each. 
(January,  1900.) 

684'  (^)  Descride  the  application  of  the  forceps  in  the  supe- 
rior strait,  naming  the  preliminary  steps,  the  position  of  the 
ivoman,  and  the  direction  of  the  traction.     {July,  1893.) 

685.  (a)  Describe  the  application  of  the  forceps  in  the 
superior  strait,  giving  precautions  to  be  observed  in  the 
delivery  of  the  foetus  in  such  a  case.     (January,  1899.) 

686.  (a)  Describe  the  use  of  the  forceps  in  the  superior 
strait.     (June,  1894.) 

687.  (c)  Describe  the  obstetric  forceps,  and  (a)  state  the 
method  of  its  application  to  the  foetal  head  in  the  superior 
strait.     (September,  1896.) 

688.  (a)  Describe  the  technique  of  the  so-called  high  forceps 
operation.     (September,  1896.) 

689.  (a)  Describe  the  high  forceps  operation.     (September, 

1891) 

690.  (a)  Describe  the  application  of  the  axis-traction 
forceps.     (June,  1900.) 


10 


86  OBSTETRICS. 

691.  (a)  Describe  the  applicatioii  of  axis-traction  forceps 
in  the  superior  strait,  giving  preliminaries  and  details. 
{April,  1897.) 

692.  (d)  Mention  the  indications  for  the  axis-traction 
forceps  and  (a)  describe  their  application.     {May,  1899.) 

693.  (d)  Mention  the  indications  for  the  axis-traction 
forceps  and  (a)  describe  their  application  at  the  brim.  {Sep- 
tember,  1901.) 

694.  {^)  Describe  the  application  of  the  forceps  to  the  foetal 
head,  movable  above  the  inlet.     {June,  1898.) 

683  to  694.  (a)  Preliminaries,  King's  Manual  of  Obstet- 
rics, pages  325;  operation,  page  336;  position,  page  339. 
Note.  As  a  guide,  introduce  the  half -hand  into  vagina, 
with  two  fingers  into  the  cervix,  before  introducing  the 
blades,  (b)  King's  Manual  of  Obstetrics,  pages  325,  326 
et  seq.  (c)  See  above,  Q.  668  to  682,  (a) ;  (d)  See  above, 
Q.  668  to  682,  (d) ;  1,  2,  3  (evidence  of  foetal  exhaustion),  4. 

695.  (a)  State  the  dangers  accompanying  the  use  of  forceps. 
{September,  1893.) 

696.  (a)  What  are  the  dangers  in  the  use  of  forceps,  and 
(b)  how  are  such  dangers  to  be  avoided?     {April]  1893.) 

695  and  696.  (a)  King's  Manual  of  Obstetrics,  page  342; 

(b)  page  325  ('Conditions  Essential  to  Safety,"  etc.);  page 
325,  last  paragraph.  See  also  description  of  proper 
method  of  operating,  pages  326  to  332. 

3.  Version. 

697.  (a)  Define  version,  (b)  name  its  varieties,  and  (c) 
state  how  it  should  be  performed.     {May,  1896.) 

698.  (a)  Define  version,  (b)  name  its  varieties,  and  (c) 
state  how  it  should  be  performed.     {September,  1896.) 

699.  (a)  Define  version,  (b)  mention  its  varieties,  and  (c) 
state  how  to. per  form  it.     {May,  1897.) 

700.  (a)   Define  version,   (b)   mention  its  varieties,   and 

(c)  describe  its  performance.     {June,  1901.) 


87  OBSTETRICS. 

701.  (b)  Mention  the  different  varieties  of  version,   and 

(c)  state  how  each  is  performed.     (June,  1898.) 

702.  (b)   What  are  the  several  varieties  of  version,  and 

(d)  when  do  they  become  perfectly  available  in  labor?     {Sep- 
tember, 1898.) 

70S.  (a)  Define  version,  (d)  state  the  conditions  under 
which  it  shoidd  be  employed,  and  (c)  show  how  it  should  be 
performed.     {January,  1899.) 

701^..  (a)  Define  version,  (b)  mention  its  varieties,  and 
(d)  state  conditions  under  which  it  should  be  employed  as 
■an  alternative.     {May,  1900.) 

705.  (a),  (c)  Describe  version,  (b)  mention  its  varieties, 
and  (d)  state  ivhen  it  is  applicable  as  an  alternative.  (Jan- 
uary, 1900.) 

706.  (b)  How  many  hinds  of  version  are  there,  arid  (d) 
what  are  the  indications  for  this  procedure?    {May,  1895.) 

707.  (b)  Mention  the  varieties  of  version,  and  (d)  state 
the  indications  for  their  employment.     {April,  1898.) 

708.  (d)  When  is  version  appropriate,  and  (c)  how  is  it 
performed?     {May,  1893.) 

709.  (a)  What  is  the  operation  of  version?  (b)  Describe 
its  varieties,  and  (d)  state  when  each  is  appropriate.  {Jan- 
uary, 1894-) 

710.  (a)  Define  version.  Give  (b)  varieties,  (d)  indica- 
tions, and  (e)  dangers  of  version,  together  ivith  (c)  prelimi- 
naries and  operation.     {June,  189 4-) 

711.  What  are  (b)  the  varieties,  and  (f)  methods  of  version? 
{January,  1892.) 

697  to  711.  (a)  King's  Manual  of  Obstetrics,  page  347; 
(b)  Cephalic  and  podalic;  (c)  King's  Manual  of  Obstetrics, 
pages  348  et  seq.  Note :  Catheterize  as  a  preliminary,  (d) 
King's  Manual  of  Obstetrics,  pages  347  and  348.  (e)  Rup- 
ture of  vagina,  cervix,  or  uterus.  Shock.  Foetal  death, 
due  to  delay  in  extraction,  from  extended  arms,  dorsally 
displaced  arms,  extended  head,-  obstruction  in  maternal 
hard  or  soft  parts.  Sepsis,  (f)  Internal,  external,  com- 
bined; and  see  King's  Manual  of  Obstetrics,  page  348. 


88  OBSTETRICS 

712.  For  what  conditions  loould  you  advise  podalic  version? 
(April,  1896.) 

712.  King's  Manual  of  Obstetrics,  page  347,  last  para- 
graph; page  348,  first  paragraph. 

718.  Describe  the  operation  of  version  by  the  internal 
method.     (January,  1898.) 

713.  King's  Manual  of  Obstetrics,  page  353  et  seq. 

714'  (a)  Under  what  conditions  should  a  head  presentation 
be  converted  into  a  foot  presentation?  (b)  How  should  this 
he  accomplished?     (May,  1902.) 

714.  (a)  See  Q.  712;  (b)  King's  Manual  of  Obstetrics, 
pages  350  et  seq. 

715.  Describe  in  detail  the  proper  procedure  when  the 
head  is  movable  above  the  brim,  but  does  not  engage.  (June, 
1900.) 

716.  Describe  in  detail  the  proper  procedure  when  the  head 
is  movable  above  the  brim  of  the  pelvis,  but  does  not  engage. 
(September,  1899.) 

715  and  716.  1.  Empty  bladder  and  rectum.  2.  Ascer- 
tain by  palpation  whether  there  is  serious  disproportion 
between  head  and  pelvis.  Press  the  head  do^niward  into 
pelvis;  this  manoeuvre  may  be  aided  by  Walcher's  position. 
If  there  is  marked  disproportion,  Csesarean  section  and 
craniotomy  must  be  considered.  (See  these  operations, 
Q.  718  to  728;  and  740  to  743.) 

If  disproportion  is  apparently  not  insuperable,  rupture 
the  membranes  just  after  the  acme  of  a  pain,  when  the 
cervix  is  fully  dilated.  If  the  head  thereupon  engages 
during  the  next  few  pains,  allow  to  deliver  spontaneously 
or  aid  mth  forceps  if  necessar}^  (See  high  forceps  indica- 
tions and  operation,  Q.  683  to  694.) 

If  it  still  refuses  to  engage,  apply  axis-traction  forceps 
in  Walcher's  position  tentatively;  if  unsuccessful,  perform 
podalic  version  by  combined  or  internal  method.  (See 
King's  Manual  of  Obstetrics,  pages  350  et  seq.) 


89  OBSTETRICS, 

If  membranes  have  already  ruptured,  note  whether  there 
is  marked  retraction-ring.  If  not,  podalic  version  is  proper, 
subject  to  hmitation  of  shght  disproportion;  but  if  the 
uterus  has  retracted  markedly,  forceps,  and,  that  failing, 
C^esarean  section,  symphyseotomy  or  craniotomy  are  alone 
admissible. 

717.  Compare  version  with  the  eviployment  of  forceps  and 
state  when  each  is  preferable.     {January,  1893.) 

717.  ^'In  flat  pelves  of  moderate  contraction  version  has 
an  advantage  over  forceps,  as  the  long  occipitomental 
diameter  of  the  foetal  head  can  be  brought  into  the  trans- 
verse of  the  inlet  and  the  occiput  guided  through  the 
roomiest  part  of  the  brim.  On  the  other  hand,  in  slight 
general  contraction  forceps  used  in  conjunction  with  the 
tValcher  position  offers  the  best  prognosis  for  mother  and 
child.  .  .  The  dexterity  and  practice  of  the  operator 
must  also  be  taken  into  consideration  in  determining  the 
relative  value  of  forceps  and  version.     .     . 

'^  The  general  rule  for  emergencies  still  holds  good — i  e., 
that  where  rapid  delivery  is  demanded  and  the  head  has 
not  engaged  at  the  pelvic  inlet,  version  is  the  operation 
of  choice,  while  forceps  is  to  be  chosen  when  the  head  is 
in  the  brim.''     (Jewett's  Practice  of  Obstetrics.) 

4.  Cutting  Operations  on  the  Mother. 

718.  (a)  Under  what  conditions  does  delivery  by  abdominal 
section  become  jiistificible,  and  (b),  (c)  luhat  is  the  technique 
of  the  operation?     (January,  1902.) 

719.  (a)  Mention  complications  of  labor  that  may  justify 
ahdomincd  section,  (b),  (c)  Give  an  illustration,  describing 
the  technique  of  the  operation.     {September,  1900.) 

720.  (a)  State  the  indications  for  C cesarean  section,  and 
(b),  (c)  describe  the  operation.     {September,  1896.) 

721.  (b),  (c)  Describe  C cesarean  section,  and  differentiate 
its  important  modifications.     {September,  1897.) 


90  OBSTETRICS. 

722.  (b),  (c)  Describe  the  classic  Ccesarean  section  and  give 
its  modifications  as  it  is  practised  at  present.     (April,  1898.) 

■■  723.  (a)  Give  the  conditions  requiring  Ccesarean  section,  and 
(b)  describe  a  modified  form  of  the  operation.    {April,  1894.) 

724.  (b) ,  (c)  Describe  the  classic  Ccesarean  section  and  the 
Sanger  and  Porro  modifications  of  this  section.     {May,  1899.) 

725.  (d)  Define  Porro^s  operation,  (e)  state  when  it  is 
applicable,  and  (c)  describe  the  method  of  its  performance. 
{June,  1900.) 

726.  (a)  What  complications  in  labor  justify  abdominal 
section?  (b)  Give  the  technique  of  the  operation.  {May, 
1897.) 

727.  (a)  Mention  the  complications  of  labor  that  may 
justify  abdominal  section,  and  (b)  describe  the  technique  of 
the  operation.     {May,  1899.) 

728.  (a)  When  is  abdominal  section  indicated  in  com- 
plicated labor?     {November,  1892.) 

729.  (g)  What  is  hysterotomy,  and  (a)  when  does  that 
operation  become  necessary?     {March,  1893.) 

730.  (f)  What  is  hysterectomy?  (e)  Give  its  proper  sphere 
in  obstetrics.     {September,  1899.) 

731.  (f)  Define  hysterectomy  and  (e)  state  when  it  is 
applicable  in  obstetric  complications.     {June,  1897.) 

718  to  731.  (a)  King's  Manual  of  Obstetrics,  page  373; 
(b)  pages  376  et  seq.  Sanger's  modification  was  tlie  intro- 
duction of  the  method  of  suturing  the  uterine  wound.  It 
is  the  operation  now  generally  performed,  (c)  King's 
Manual  of  Obstetrics,  pages  381  et  seq.;  (d)  pages  381  et 
seq.;  (e)  page  382;  (f)  ^^Hysterectomy  is  excision  of  the 
uterus;  it  may  be  performed  by  laparotomy  or  through  the 
vagina"  (Dusme^s  Medical  Dictionary);  (g)  ^^Hysterotomy 
is  the  act  of  incising  the  uterus,  either  through  the  abdo- 
men {laparo-hysterotomy)  or  the  vagina  {vaginal  hyster- 
otomyY'  {DnB.n.e's  Medical  Dictionary).  -^         '  ^'J  '  '    ' - 

■  732.  (a)  Describe  symphyseotomy,  and  (b)  give  indications 
for  its  performance.     {November,  1893.) 


91  OBSTETRICS. 

733.  (c)  Define  symphyseotomy,  (b)  state  when  it  is  ad- 
missible, and  (a)  describe  its  technique.     {September,  1901.) 

734.  (b)  Give  the  indications  for  the  operation  of  syinphys- 
eotomy.     (a)  Describe  this  operation.     {May,  1898.) 

736.  (b)  When  is  symphyseotomy  indicated?  (a)  Describe 
the  operation.     {April,  1895.) 

736.  (c)  What  is  symphyseotomy?  (a)  How  and  (b) 
for  ivhat  reason  is  this  operation  performed?  {September^ 
1894.) 

737.  (b)  What  are  the  indications  for  symphyseotomy, 
and  (a)  hoio  shoidd  the  operation  be  performed?  {Sep- 
tember, 1895.) 

738.  (b)  When  may  symphyseotomy  become  an  appro- 
priate alternative  as  an  obstetric  operation,  and  (a)  how  should 
this  operation  be  performed?     {June,  1899.) 

732  to  738.  (a)  King's  Manual  of  Obstetrics,  pages  367 
et  seq.;  (b)  page  365 ;  (c)  page  364. 

739.  What  is  episiotomy,  and  when  is  such  interference 
indicated?     {May,  1896.) 

739.  Lateral  incision  of  the  vulva. 

^'When  extensive  laceration  at  the  vaginal  outlet  is 
otherwise  inevitable,  incisions  may  be  made  on  either  side. 
Episiotomy  substitutes  for  a  posterior  laceration,  which 
is  often  difficult  of  complete  repair,  incisions  through 
less  important  structures,  which  can  easily  and  perfectly 
be  closed  by  suture."     (Jewett's  Practice  of  Obstetrics.) 

5.  Mutilating  Operations  on  the  Child. 

740.  (a)  Under  what  conditions  should  craniotomy  be 
performed?     (b)  Describe  the  operation.     {April,  1899.) 

741 '  (a)  What  are  the  indications  for  craniotomy,  and 
(c)  what  are  its  alternatives?     {January,  1892.) 

742.  (a)  When  does  it  become  proper  to  perform  crani- 
otomy, and  (b)  how  is  that  operation  performed?  {April, 
1893.) 


92  OBSTETRICS. 

743.  (d)  Define  embryotomy  and  craniotomy,  and  give 
(a),  (e)  the  indications  for  and  (b),  (f)  method  of  operating 
in  each.     {June,  1893.) 

744.  (f)  Give  the  various  steps  in  embryotomy  on  the 
transverse  presentation.     (May,  1895.) 

740  to  744.  (a)  King's  Manual  of  Obstetrics,  page  386; 
(b)  pages  387  et  seq.  (c)  Induction  of  premature  labor; 
symphyseotomy;  Csesarean  section,  (d)  King's  Manual  of 
Obstetrics,  page  386;  (e)  page  400;  (f)  page  400. 

XXV.    COMPLICATIONS  OF  THE  PUERPERIUM. 

745.  Mention  the  pathogenic  bacteria  that  invade  the 
vagina,  and  state  how  the  vagina  is  normally  protected  from 
them.     (May,  1901.) 

745.  Streptococcus,  staphylococcus,  gonococcus,  bacillus 
coli  commmiis,  bacillus  diphtherise,  bacillus  aerogenes  cap- 
sulatus,  pneumococcus,  bacillus  typhosus,  and  bacteria 
of  putrefaction.  The  vaginal  mucus  is  antiseptic,  and  is 
secreted  in  large  quantities  before  and  during  labor. 

746.  What  is  meant  by  autoinfection  during  or  after  labor, 
and  how  does  it  originate?     {June,  1892.) 

746.  ^'Many  believe  that  in  a  certain  number  of  cases 
[of  puerperal  infection]  the  infection  is  not  due  to  the 
introduction  of  organisms  from  without,  but  owes  its  origin 
to  micro-organisms  which  were  within  the  woman  before 
the  onset  of  labor.  To  infections  arising  in  this  way  the 
term  '  autoinfection'  is  applied.  The  conception  was  intro- 
duced by  Kaltenbach  that  in  a  considerable  number  of 
cases  pathogenic  organisms  are  normally  found  in  the 
vaginae  of  pregnant  women,  which  may  be  introduced 
into  the  uterus  by  the  introduction  of  a  perfectily  sterile 
finger  within  the  vagina."  (Jewett's  Practice  of  Obstet- 
rics.) 

747.  (a)  What  is  puerperal  fever,  and  (b)  what  are  its 
causes?     {November,  1892.) 


93  OBSTETRICS. 

748.  (b)  Name  the  favorable  conditions  for  sepsis  in  the 
puerperium.     {April,  1894.) 

749.  (b)  What  are  the  principal  causes  of  puerperal 
infection?  (c)  How  may  puerperal  infection  he  prevented? 
(September,  1899.) 

750.  (a)  What  do  you  understand  by  the  term  puerperal 
sepsis,  and  (c)  hoiv  would  you  attempt  to  prevent  it?  {June, 
1893.) 

751.  (a)  Define  puerperal  sepsis,  and  (c)  state  what  should 
he  done  to  prevent  it.     {January,  1897.) 

752.  (a)  Define  puerperal  sepsis,  and  state  both  (c)  how  to 
prevent  it  and  (d)  how  to  overcome  it.     {June,  1897.) 

753.  (c)  What  means  should  be  employed  to  avoid  sepsis 
in  the  puerperal  state?     {March,  1892.) 

754.  (c)  What  precautions  shoidd  be  taken  against  in- 
fection during  labor  and  in  the  puerperal  state?  {June, 
1898.) 

755.  (c)  Hoiv  should  a  case  of  labor  be  conducted  to  avoid 
puerperal  infection?  (d)  What  would  he  the  proper  manage- 
ment if  infection  should  occur?     {January,  1901.) 

756.  How  should  puerperal  infection  be  (c)  guarded  against 
and  (d)  managed  when  present?     {May,  1900.) 

757.  How  may  puerperal  sepsis  be  (b)  engendered,  (c) 
prevented,  (d)  managed?     (January,  1900.) 

758.  (b)  Mention  the  principal  sources  of  puerperal  sepsis, 
and  give  details  of  (c)  prevention  and  (d)  of  treatment.  (Jan- 
uary, 1899.) 

759.  (a)  What  is  puerperal  septiccemia?  (c)  How  is  it 
prevented,  and  (d)  hoio  treated  when  it  does  occur?  (April, 
1893.) 

760.  Give  the  (e)  symptoms  and  (d)  treatment  of  sepsis 
or  autoinfection  in  the  puerperal  state.     (March,  1893.) 

761.  (a)  Define  and  (b)  7iame  the  predisposing  causes 
of  puerperal  infection;  also  give  the  (c)  prophylaxis,  (e) 
symptoms,  and  (d)  treatment  of  puerperal  sepsis.  (Sep- 
tember, 1893.) 


11 


94  .  OBSTETRICS. 

762.  (a)  What  is  puerperal  sepsis?  How  may  it  he  (c) 
prevented  and  (d)  cured?     (September,  189 Jj..) 

763.  Give  the  (e)  symptoms  and  (d)  treatment  of  puerperal 
sepsis.     {January,  1896.) 

764.  (a)  Define  puerperal  sepsis,  and  state  its  (b)  causes, 
(c)  prophylaxis,  and  (d)  treatment.     (September,  1898.) 

765.  (a)  Define  puerperal  infection,  and  state  its  (b) 
essential  causes.  Give  the  (e)  symptoms,  (c)  prophylaxis, 
and  (d)  treatment  of  puerperal  sepsis.     (September,  1897.) 

766.  (a)  Define  puerperal  septicaemia.  State  its  (b) 
causes  and  (c),  (d)  its  management.     (April,  1897.) 

767.  Describe  the  (c)  prophylactic  and  (d)  curative  treat- 
ment of  septiccemia.     (July,  1893.) 

768.  Give  the  (e)  symptoms  and  (d)  treatment  of  puerperal 
fever.     (March,  1892.) 

769.  Give  (e)  diagnosis  and  (d)  treatment  of  puerperal 
fever.     (January,  189  Jf..) 

747  to  769.  (a)  King's  Manual  of  Obstetrics,  page  533; 
(b)  pages  534  et  seq.;  (c)  pages  546  and  215;  (d)  pages  547 
et  seq.;  (e)  pages  540  et  seq. 

770.  What  is  milk  fever?  Describe  its  occurrence  and 
treatment.     [June,  1892.) 

770.  King's  Manual  of  Obstetrics,  page  249. 

771.  (a)  Define  puerperal  phlebitis,  and  (b),  (c)  give  its 
pathology,  (d),  (e)  symptoms,  and  (f),  (g)  treatment.  (Mo.y, 
1901.)  ' 

772.  State  the  (h)  causes,  (h),  (c)  pathology,  (d),  (e) 
symptoms,  and  (f),  (g)  treatment  of  puerperal  phlebitis. 
(May,  1900.) 

773.  Give  the  (b),  (c)  pathology,  (d),  (e)  symptoms,  and 
(f),  (g)  management  of  puerperal  phlebitis.     (June,  1899.) 

77 Jj..  State  the  (h)  causes,  (d),  (e)  symptoms,  and  (f),  (g) 
management  of  puerperal  phlebitis.     (April,  1898.) 

775.  (f),  (g)  How  would  you  treat  puerperal  phlebitis? 
(June,  1893^ 


95  OBSTETRICS. 

776.  Give  the  (h)  causes,  (cl),  (e)  symptoms,  (f),  (g)  treat- 
ment, and  (i)  sequelce  of  puerperal  phlebitis.     (May,  1895.) 

777.  (h)  Give  the  causes  and  (f),  (g)  treatment  of  puerperal 
phlebitis.     (September,  1902.) 

771  to  777.  (a)  King's  Manual  of  Obstetrics,  page  543; 

(b)  page  543;  (c)  page  555;  (d)  page  543;  (e)  page  555; 
(f)  pages  539  and  546;  (g)  pages  539  and  555;  (h)  pages 
539;  547  et  seq.,  and  555:  (i)  Uterine  phlebitis,  thrombosis, 
pyaemia,  and  septicaemia.  Crural  swelling,  impairment  of 
motion,  liability  to  relapse. 

778.  (a)  What  is  phlegmasia  alba  dolens?  (b)  Give 
treatment.     (April,  1899.) 

779.  (a)  Describe  phlegmasia  alba  dolens  (milk  leg),  its 

(c)  causes,  (d)  nature,  and  (b)  treatment.     (June,  1892.) 

780.  Give  the  varieties,  (e)  symptoms,  and  (b)  treatment 
of  phlegmasia  dolens.     (April,  1894-.) 

778  to  780.  (a)  King's  Manual  of  Obstetrics,  page  562; 
(b)  pages  563  and  564;  (c)  page  562;  (d)  page  562;  (e) 
page  562. 

781.  (a)  What  are  the  uses  of  the  vaginal  douche  during 
and  after  labor?     (November,  1892.) 

782.  (a)  Mention  the  indications  for  the  obstetric  employ- 
ment of  the  vaginal  douche,  and  (b)  state  the  technique  of 
its  application.     (April,  1898.) 

783.  (a)  State  under  what  circumstances  the  vaginal  douche 
may  be  employed  before,  during,  and  after  labor,  (b)  Give 
the  technique.     (May,  1897.) 

78Ij..  (a)  When  should  the  ante-partum  antiseptic  douche 
be  employed?  (b)  Give  the  details  of  its  use.  (January, 
1896.) 

781  to  784.  (a)  Before  labor:  1.  To  induce  premature 
labor;  2.  As  prophylactic  in  cases  of  suspicious  or  un- 
doubtedly infective  vaginal  discharge.  During  labor:  As 
preliminary  to  version,  forceps,  or  embryotomy.  After 
labor:  1.  Many  obstetricians  give  routine  douche  for  the 


96  OBSTETRICS, 

sake  of  cleanliness;  2.  In  case  of  foul  lochia;  3.  After  repair 
of  perineal  lacerations;  4.  As  an  element  of  treatment  of 
puerperal  sepsis,  (b)  Apparatus:  Fountain  syringe,  hold- 
ing from  two  to  four  quarts ;  sterilized  glass  douche-nozzle ; 
Kelly  pad.  Hot  2  per  cent,  creolin  mixture  in  boiled  water 
(110°  to  120°  F.).  Position:  Dorsal,  crosswise  of  bed,  knees 
drawn  up,  on  inflated  Kelly  pad,  apron  of  which  dips  into 
empty  pail  at  bedside.  Preliminaries:  Disinfect  hands; 
clean  external  genitals  with  bichloride  solution  (1  to  2000) ; 
allow  all  air  to  escape  from  tube  and  nozzle ;  separate  labia 
with  one  hand,  while  the  other  introduces  douche-nozzle 
to  posterior  fornix;  move  nozzle  about,  to  reach  every 
portion  of  the  vagina,  but  do  not  obstruct  the  free  outflow 
by  compression  of  the  introitus. 

755.2(a)  What  are  the  indications  for  intra-uterine  irri- 
gation after  labor,  and  (b)  how  shoidd  it  he  performed? 
{June,  1892.) 

786.  (b)  Describe  the  technique  of  intra-uterine  irrigation, 
and  (a)  state  when  its  employment  is  justifiable.    {May,  1896.) 

785  and  786.  (a)  After  all  intra-uterine  manipulations: 
Version,  high  forceps,  embryotomy,  manual  extraction  of 
placenta;  post-partum  hemorrhage ;  uterine  infection,  (b) 
Apparatus:  Fountain  syringe;  Kehy  pad;  long,  curved, 
sterile  douche-nozzle;  hot,  sterile,  saline  solution.  Pre- 
liminaries as  above,  Q.  781  to  784.  (b)  Introduce  two  fui- 
gers  of  left  hand  into  vagina,  to  the  posterior  lip  of  cervix. 
Avoid  carrying  m  infective  material  from  the  external 
genitals.  With  these  fingers  as  guide,  introduce  douche- 
nozzle  (having  first  expelled  all  air)  into  cervix.  Transfer 
hand  from  vagina  to  abdomen  and  continue  introduction 
of  tube  gently  up  to  fundus  uteri.  (King's  Manual  of  Ob- 
stetrics,|pages  547  et  seq.  -    .         .     -  ^  - 

181 .  (a)  When  is  curettage  of  the  uterus  justifiable  in 
obstetric  practice,  and  (b)  how  should  it  be  performed?  {June, 
1900.) 


97  OBSTETRICS. 

788.  (c)  Define  uterine  curettage,  (a)  Give  the  indications 
for  curettage,  and  (b)  describe  its  technique.     (May,  1902.) 

789.  (a)  Under  ivhat  circumstances  may  the  curette  become 
necessary,  and  (b)  what  precautions  should  be  taken  in  its 
use?  (d)  State  the  dangers  attending  the  use  of  the  curette. 
(January,  1902.) 

787  to  789.  (a)  1.  Incomplete  abortion;  2.  Sepsis  caused 
by  retained  placenta,  blood  clot,  membranes,  (b)  Crockett's 
Gynecology,  pages  51  to  53.  (c)  Scraping  the  uterine  mu- 
cous membrane,  (d)  1.  Laceration  of  cervix;  2.  Perforation 
of  uterine  wall;  3.  Sepsis. 

790.  (a)  What  is  puerperal  mcinia?  When  does  it  occur, 
and  (b)  whcd  are  its  causes?     {March,  1893.) 

791.  What  are  the  (c)  symptoms  and  (d)  treatment  of 
p^ierpercd  mania?     {April,  1893.) 

792.  Give  the  (b)  causes  and  (c)  describe  the  clinical 
phenomena  of  puerperal  mania.     {September,  1896.) 

793.  (a)  Define  puerperal  mania.  Give  its  (b)  etiology, 
(c)  symptoms,  and  (d)  treatment.     {September,  1897.) 

790  to  793.  (a)  King's  Manual  of  Obstetrics,  pages  566 
and  565;  (b)  pa2:e  566;  (c)  page  567;  (d)  pages  568  and 
569. 

794.  (a)  Define  mastitis.  State  its  (b)  etiology,  and  give 
its  treatment,  (d)  preventive  and  (e)  curative.  {September, 
1897.)  ■ 

795.  (a)  Define  mastitis,  and  give  its  (b)  causes,  (d) 
prevention,  and  (e)  treatment.     {September,  1896.) 

796.  Give  the  (f)  varieties,  (b)  etiology,  (c)  symptoms, 
and  (e)  treatment  of  mastitis.     {November,  1894.) 

797.  Give  the  (b)  etiology,  (e)  treatment,  and  (g)  com- 
plications of  mastitis.     {May,  1896.) 

798.  (a)  What  is  inastitis,  and  (e)  how  should  it  he  treated? 
{September,  1893.) 

799.  What  is  the  (h)  pathology  of  puerperal  mastitis? 
(e)  Stcde  how  puerperal  mastitis  shoidd  be  treated.  {June, 
1901.) 


98  OBSTETRICS. 

800.  Give  the  (b)  causes,  (c)  symptoms,  and  (i)  treatment 
of  mammary  abscess  in  the  puerperal  state.  (November, 
1891.) 

801.  State  the  (b)  causes  of  mammary  abscess  in  the 
puerperal  state,  and  give  its  (c)  symptoms  and  (i)  treatment. 
(April,  1897.) 

794  to  801.  (a)  King's  Manual  of  Obstetrics,  page  571; 
(b)  page  572;  (c)  pages  572  et  seq.;  (d)  page  249  C^sore 
nipples'');  (e)  pages  574  et  seq.;  (I)  page  571;  (g)  Abscess, 
general  septic  infection;  (h)  King's  Manual  of  Obstetrics, 
page   571;  (i)  page  575. 


XXVI.  GYNECOLOGY. 

80S.  Give  the  (a)  causes  and  (b)  treatment  of  imperforate 
hymen.     [June,  1895.) 

803.  How  may  imperforate  hymen  with  long-retained 
menstrual  fluid  be  (c)  recognized  and  (b)  treated?  (Sep- 
tember, 1898.) 

804.  (c)  Make  a  diagnosis  of  imperforate  hymen,  and 
(b)  state  its  treatment  in  a  case  of  long-retained  menstrual 
fluid.     (April,  1897.) 

805.  (c)  Mention  the  symptoms,  and  (b)  gi've  the  manage- 
ment of  long-retained  excretions  due  to  imperforate  hymen. 
(September,  1899.) 

802  to  805.  (a)  Crockett's  Gynecology,  page  340;  (b) 
page  342;  (c)  page  341. 

806.  (a)  What  is  vaginismus?    How  may  vaginismus  be 

(b)  recognized  and  fc)  treated?     (September,  1900.) 

807.  (a)  What  is  vaginisinus?    Give  the  (d)  causes  and 

(c)  treatment  of  vaginismus.     (January,  1902.) 

808.  (a)  Define  vaginismus,  (e)  vaginitis.  Give  the  (c),  (f) 
treatment  of  each  condition.     (September,  1902.) 

'  806  to  808.  (a)   Crockett's  Gynecology,   page  90;   (b) 
page  90;  (c)  page  90;  (d)  page  90;  (e)  Inflammation  of 


99  OBSTETRICS. 

the  mucous  membrane  of  the  vagina;  (f)  Crockett's  Gyne- 
cology, page  87. 

809.  What  is  a  taviponf  How  is  it  made,  and  when  is 
it  properly  used?     {November,  1892.) 

810.  What  is  a  tampon?  How  is  it  made,  and  what  are 
its  proper  uses?     (September,  18 93.) 

811.  What  precautions  are  to  be  observed  in  the  use  of 
the  tampon?     {January,  1895.) 

809   to   811.  Crockett's   Gynecology,    pages   38   to  41. 

812.  Describe  the  uterine  tampon,  its  uses,  its  dangers, 
and  state  what  precautions  should  be  observed  when  employ- 
ing it.     {September,  1896.) 

813.  Describe  a  uterine  tampon.  State  its  uses  and  dangers 
and  indicate  the  precautions  that  shoidd  be  observed  in  its 
employment.     {May,  1902.) 

812  and  813.  Crockett's  Gynecology,  pages  43  and  42. 
Dangers:  Perforation  in  introducing;  sepsis;  shock. 

814.  Name  the  diseases  of  the  endometrium,  and  state 
their  effects  in  pregnancy.     {September,  1894.) 

814.  Acute  endometritis;  chronic  endometritis: — (a) 
Chronic  diffuse;  (b)  Chronic  polypoid;  (c)  Catarrhal;  {d) 
Hydrorrhcea  gravidarum.  (Jewett's  Practice  of  Obstetrics.) 
They  are  very  apt  to  cause  abortion  or  adherent  placenta 
at  term. 

815.  (a)   Define  endometritis,   and  give  its   (b)   causes, 

(c)  varieties,  and  (d)  treatment.     (January,  1901.) 

816.  (a)  Define  endometritis,  and  give  its  (d)  treatment. 
(May,  1902.) 

817.  (a)  Define  endometritis,  and  fd)  state  hoio  it  should 
he  treated.     (Septeynber,  1900.) 

818.  Give  the  (h)  causes,  (e)  pathology,  (f)  symptoms,  and 

(d)  treatment  of  endometritis.     (September,  1901.) 

815  to  818.  (a)  Inflammation  of  the  uterus,  manifested 
most  prominently  in  its  mucous  membrane;  (b)  Crockett's 
Gynecology,  pages  95  and  99;  (c)  pages  95  and  99;  (d) 


100  OBSTETRICS. 

pages  97  and  106;  (e)  pages  95  and  100;  (f)  pages  96 
and  102. 

819.  Describe  the  various  forms  of  inflammation  of  the 
uterus.     (November,  1892.) 

819.  Crockett^s  Gynecology,  pages  95  and  100. 

820.  (a)  HoiD  do  uterine  displacements  originate,  and 
how  do  they  influence  (b)  conception  and  (c)  pregnancy? 
{June,  1894.) 

821.  What  influence  upon  (b)  conception  and  (c)  preg- 
nancy have  uterine  displacements?     (September,  1892.) 

822.  Mention  the  uterine  displacements  that  are  liable  to 
influence  (b)  conception,  (c)  pregnancy,  and  (d)  labor,  and 
state  the  manner  of  such  influence.     (June,  1901.) 

820  to  822.  (a)  Crockett's  Gynecology,  pages  284,  244 
and  259;  (b)  page  288,  third  paragraph;  (c)  King's  Manual 
of  Obstetrics,  pages  151  to  156;  (d)  pages  154  and  156. 

823.  What  uterine  displacement  is  liable  to  interrupt 
pregnancy,  and  what  should  be  done  to  prevent  it?  (Jan- 
uary, 1898.) 

824.  How  would  you  diagnose  and  treat  retroversion  of 
the  gravid  uterus?     (March,  1892.) 

823  and  824.  King's  Manual  of  Obstetrics,  pages  152 
to  155. 

826.  Differentiate  (a)  anteversion  and  (b)  retroversion, 
(c),  (d)  stating  the  obstetric  significance  of  each.  (September, 
1899.) 

826.  Describe  and  differentiate  (a)  anteversion,  (b)  retro- 
version, and  (e)  prolapsus  of  the  uterus.     (June,  1900.) 

827.  Define  and  differentioAe  (a)  anteversion  and  (b) 
retroversion  of  the  uterus,  (f),  (g)  State  what  should  be  done 
for  the  relief  of  each.     (January,  1901.) 

828.  (a),  (b)  Give  a  differential  diagnosis  of  anteversion 
of  the  uterus  and  retroversion  of  the  uterus,  (f),  (g)  State 
what  may  be  done  to  correct  each.     (June,  1902.) 

825  to  828.  (a)  Crockett's  Gynecology,  pages  260  and 


101  OBSTETRICS. 

261;  (b)  pages  244  to  247;  (c)  King's  Manual  of  Ob- 
stetrics, page  155;  (d)  page  152;  (e)  Crockett's  Gynecology, 
pages  234  to  239;  (f)  page  261;  (g)  pages  248  to  259. 

829.  Under  what  conditions  may  shortening  of  the  round 
ligaments  become  justifiable,  and  hoio  should  the  operation 
he  performed?     (May.  1900.) 

829.  Crockett's  Gynecology,  page  254. 

830.  Is  ventrofixation  of  the  uterus  justifiable?  If  so, 
state  under  what  circumstances,  and  describe  the  operation. 
{June,  1900.) 

830.  Crockett's  Gynecology,  page  257. 

831.  How  shoidd  a  case  of  .fibroid  tumor  complicating 
pregnancy  be  treated?     {June,  1902.) 

831.  King's  Manual  of  Obstetrics,  page  509. 

832.  (a)  What  symptoms  lead  to  the  suspicion  of  malignant 
disease  of  the  uterus?     {May,  1902.) 

833.  Give  the  (b)  early  diagnosis  and  the  (c)  treatment 
of  cancer  of  the  uterus.     {May,  1898.) 

832  and  833.  (a)  Crockett's  Gynecology,  page  178;  (b) 
pages  179  and  180;  (c)  pages  180  to  189. 

83Jf..  (a)  Define  menstruation,  its  clinical  course,  and  (b) 
abnormalities.     {September,  1893.) 

835.  (b)  Describe  the  abnormalities  of  menstruation,  and 
give  their  (c)  etiology  and  (d)  treatment.    {September,  1895.) 

834  and  835.  (a)  See  Q.  22,  and  Crockett's  Gynecology, 
page  267;  (b)  Amenorrhoea;  d3^smenorrhoea ;  menorrhagia ; 
metrorrhagia;  vicarious  menstruation,  (c),  (d)  Crockett's 
Gynecology,  pages  272  to  286  and  269,  third  paragraph. 

836.  What  are  the  symptoms  and  treatment  of  amenorrhoea? 
{April,  1893.) 

836.  Crockett's  Gynecology,  pages  272  et  seq. 

837.  Define  dysmenorrhcea  and  give  its  varieties,  causes, 
and  treatment.     {January,  1902.) 

837.  Crockett's  Gynecology,  pages  279  et  seq. 


12 


102  OBSTETRICS. 

838.  What  is  vicarious  menstruationf     {June,  1893.) 

838.  Crockett's  Gynecology,  page  269. 

839.  What  methods  should  he  employed  to  dilate  the  non- 
pregnant uterus,  and  under  ivhat  circumstances  is  the  oper- 
ation justifiable?     {June,  1901.) 

839.  Crockett's  Gynecology,  pages  51,  97  and  285. 

840.  Mention  two  distinct  methods  of  dilatation  of  the 
cervix  uteri  iri  obstetric  practice,  and  describe  in  detail  one 
of  the  operations.     {June,  1898.) 

840.  King's  Manual  of  Obstetrics,  page  434;  Crockett's 
Gynecology,  page  51. 

841'  (a)  Define  salpingitis,  (b)  state  its  causes,  and  (c)  give 
its  management.     {September,  1900.) 

842.  (a)  Define  salpingitis,  and  give  its  (cl)  pathology 
and  (c)  treatment.     {January,  1901.) 

843.  Give  the  (b)  causes,  (cl)  pathology,  and  (c)  treatment 
of  salpingitis.     (June,  1902.) 

844-  Gi^^^  the  pathology  of  (e)  hydrosalpinx ,{i)  hcemato- 
salpinx.  (g)  Give  the  diagnosis  and  (h)  treatment  of  each, 
{May,  1901.) 

841  to  844.  (a)  Crockett's  Gynecology,  page  110;  (b) 
page  110;  (c)  pages  127  to  139;  (cl)  page  111;  (e)  page  115; 
(f)  page  114;  (g)  pages  121,  second  paragraph;  124,  para- 
graphs four  and  five.  Note:  If  blood  has  coagulated, 
in  hsematosalpinx,  the  tube  will  have  a  firmer,  non-fluctuat- 
ing feel,  (h)  Crockett's  Gynecology,  pages  127  et  seq.  Note 
page  133. 

84s.  Give  a  differential  diagnosis  between  ovaritis  and 
ovaralgia.     {January,  1893.) 

845.  Pain  and  tenderness  are  fairly  constant  in  ovaritis; 
in  ovaralgia  there  may  be  spontaneous  pain,  relieved  or 
increased  by  pressure.  Pressure  on  neuralgic  ovary  is  often 
productive  of  hysterical  symptoms,  palpitation,  globus 
hystericus,  convulsions.  Bimanual  examination  is  negative 
in  ovaralgia ;  in  ovaritis  the  ovary  is  usually  enlarged,  often 
uneven  in  contour,  and  bound  down  by  adhesions. 


103 


OBSTETRICS. 


8Jj6.  How  would  you  diagnose  cystic  degeneration  of  the 
ovaries  from  other  forms  of  disease  which  simulate  it?  {Sep- 
tember, 1892.) 

846.  Crockett's  Gynecology,  pages  210  and  215. 

847.  Give  the  pathology  and  treatment  of  an  ovarian  cyst. 
{June,  1901.) 

847.  Crockett's  Gynecology,  pages  196  et  seq.,  and  215. 

848.  Describe  and  differentiate  pelvic  celliditis  and  pelvic 
peritonitis.     {March,  1892.) 

848.  Crockett's  Gynecology,  pages  117,  118,  121  and  122. 
The  following  table  is  from  Findley's  Gynecological  Diag- 


nosis: 


Pelvic  Cellulitis. 

Pelvic  Peritonitis. 

1. 

Exudate  lies  low  in  the  pelvis. 

1. 

Lies  high  in  the  pehds. 

2. 

Pain  may  not  be  great,   and  is 

2. 

Pain  usually  more  intense,  sharp, 

dull  and  continuous. 

lancinating,  and  parox^'smal. 

3. 

Exudate   commonly  at  the  side 

3. 

Exudate   commonly  behind    the 

of  the  uterus,  never  extending 

uterus,  often  extending  to  the 

to  the  fundus. 

fundus. 

4. 

Exudate    of     firm    consistency; 

4. 

Commonly   less   firm;     no    great 

tendency  to  suppuration. 

tendency  to  suppuration. 

5. 

Uterus  partially  fixed. 

5. 

Uterus  may  be  firmly  fixed. 

6. 

Tympanites  usually  absent. 

6. 

Tj-mpanites  usually  present. 

7. 

Facial  expression  may  be  natural. 

7. 

Facial  expression  anxious. 

8. 

Nausea  and  vomiting  not  com- 

8. 

Nausea  and  vomiting  common. 

9. 

mon. 
One  leg  flexed. 

9. 

Both  legs  flexed. 

8Jfi.  State  the  (a)  causes,  (b)  symptoms,  and  (c)  treatment 
of  pus  in  the  pelvis.     {September,  1901.) 

860.  Give  the  (a)  causes  of  pelvic  inflammation,  and 
(d)  state  its  relation  to  involvement  of  the  ovary.  {Sep- 
tember, 1896.) 

849  and  850.  (a)  Crockett's  Gynecology,  page  110;  (b) 
pages  122  (cellulitis)  and  124;  (c)  page  137;  (d)  page  116, 
second  paragraph. 

851.  Give  the  diagnosis,  causes,  and  treatment  of  pelvic 
hoematocele.     {May,  1893.) 


104  .  OBSTETRICS. 

851.  Causes:  Extra-uterine  pregnancy;  rupture;  torn 
peritoneal  adhesions.  Systemic  diseases :  smallpox;  scarla- 
tina; jaundice.  Diagnosis:  Crockett's  Gynecology,  page 
125;  King's  Manual  of  Obstetrics,  page  185.  Treatment: 
Crockett's  Gynecology,  page  129. 

8S^.  (a)  State  some  of  the  most  common  causes  of  sterility. 
{June,  1895.) 

853.  (a)  Mention  some  of  the  essential  causes  of  sterility 
in  women,  (b)  State  how  fertility  may  he  developed  in  the 
sterile.     {April,  1897.) 

854.  (a)  Mention  some  of  the  usual  causes  of  sterility 
in  women,  and  (b)  state  how  they  may  he  overcome.  {June, 
1897.) 

855.  (a)  What  are  some  of  the  essential  causes  of  sterility 
in  woman,  and  (b)  what  can  he  done  to  remove  them?  {Sep- 
tember, 1898.) 

856.  (a)  Mention  the  most  essential  causes  of  sterility  in 
woman,  and  (b)  state  how  fertility  may  he  promoted.  {Jan- 
uary, 1899.) 

857.  (a)  What  are  some  of  the  principal  causes  of  sterility 
in  woman?  (b)  How  may  fertility  in  woman  he  jjromotedf 
(Jauary,  1900.) 

858.  (a)  Mention  some  of  the  principal  causes  of  sterility 
in  ivoman,  arid  (b)  state  how  fertility  may  he  promoted. 
{Septemher,  1900.) 

859.  (a)  Mention  the  principal  causes  of  sterility  in 
woman,  arid  (b)  describe  methods  hy  which  fertility  may  he 
promoted.     {January,  1901.) 

852  to  859.  (a)  Crockett's  Gynecology,  pages  287  to 
289;  (b)  page  290. 

860.  To  what  dangers  from  pregnancy  and  lahor  does 
gonorrhoea  of  the  mother  expose  her  and  her  offspring. 

860.  Mother:  Abortion;  puerperal  sepsis.  Child:  oph- 
thalmia neonatorum  with  consequent  blindness. 


105  OBSTETRICS. 


XXVII.    MISCELLANEOUS. 


861.  Describe  the  anatomical  cliff erences,  not  includiiig 
the  sexual  organs,  between  the  male  and  the  female  figure. 
{June,  1901.) 

862.  Give  a  non-sexual  anatomical  description  of  the 
mcde  and  female  figures  in  outline,  differentiating  them. 
{June,  1900.) 

863.  Give  a  non-sexual  anatomiccd  differ efritiation  of  the 
male  and  femcde  figures.     {September,  1899.) 

861  to  863.  In  the  female  the  bones  are  hghter,  less 
prominent,  and  less  strong;  the  lines  and  prommences  less 
pronounced.  The  sternum  is  shorter;  the  pelvis  has  well- 
marked  and  characteristic  differences,  for  which  see  King's 
Manual  of  Obstetrics,  pages  26  and  27.  The  female  has 
more  subcutaneous  fat;  hence  the  more  rounded  appear- 
ance of  the  body.  There  is  less  hair  on  the  female  body, 
particularly  on  the  face,  chest,  abdomen,  and  limbs;  the 
pubic  hair  does  not  grow  upward  toward  the  mnbilicus 
as  in  the  male.  The  larynx  is  smaller  in  the  female,  the 
hips  are  wider,  and  the  waist  smaller  as  compared  with 
the  chest;  the  breasts  are  larger. 

864.  Describe  the  obstetric  uses  of  water.    {September,  1892.) 

864.  1.  Cleansing;  2.  vehicle  for  antiseptics;  3.  as  enema, 
cathartic;  4.  as  saline  enema  or  hypoclermoclysis,  diluent 
of  body  toxins  in  eclampsia  and  sepsis;  5.  applied  cold 
externally,  stmiulant  to  uterine  contraction,  and  to  inspi- 
ration in  the  newborn;  6.  hot,  as  adjuvant  in  asphyxia 
neonatorum;  7.  in  douche,  as  an  agent  for  inducing  abortion. 

865.  (a)  Describe  the  knee-chest  posture,  and  (b)  state  its 
obstetric  applications.     (September,  1901.) 

865.  (a)  King's  Manual  of  Obstetrics,  page  515;  (b) 
King's  Manual  of  Obstetrics,  page  152;  Retroversion, 
prolapsus  funis,  page  515;  precipitate  labor. 


106  OBSTETRICS^ 

866.  State  the  medico-legal  complications  that  may  arise 
from  an  erroneous  diagnosis  of  pregnancy.  (September, 
1899.) 

866.  King's  Manual  of  Obstetrics,  pages  102,  103,  589 
and  593.  In  addition  the  paternity  of  the  child  is  involved, 
as  also  the  mother's  right  to  demand  from  the  father  sup- 
port for  the  child. 

867.  How  many  cases  of  labor  have  you  attended,  assisted 
at,  or  witnessed?  Describe  the  most  complicated  case  that 
you  have  delivered.     {May,  1900.) 

868.  State  hoiv  mayiy  cases  of  labor  you  have  attended 
without  professional  assistance.  Describe  the  most.,  com- 
plicated case  that  you  have  delivered.     (June,  1900.) 

869.  How  many  cases  of  labor  have  you  attended,  assisted 
at,  or  witnessed?  Describe  the  most  complicated  case  that 
you  have  delivered.     (September,  1900.) 

870.  How  many  cases  of  labor  have  you  conducted  inde- 
pendently? Give  a  brief  description  of  the  most  complicated 
case.     (January,  1901.) 


APPENDIX. 


Questions  asked  January,  1903. 

871 .  Give  in  consecutive  detail  the  jjhysiological  phenomena 
pertaining  to  reproduction  of  the  species. 

871.  See  Q.  43  to  78,  (e),  (g),  and  (1). 

872.  Give  (a)  the  prohahle  symptoms  of  pregnancy  before 
quick&iiing,  (b)  the  positive  symptoms  of  jwegnancy  after  four 
and  one-half  months. 

872.  (a)  King's  Manual  of  Obstetrics,  page  116,  ^' first 
five,''  and  Hegar's  sign;  (b)  pages  103  and  104,  omitting 
Hegar's  sign. 

873.  (a)  Mention  the  symptoms  of  approaching  labor  and 
(b)  state  the  preparations  that  should  be  made  when  they  occur. 

873.  (a)  See  Q.  272  and  273;  (b)  See  Q.  287  and  288. 

87 J},.  Describe  the  management  of  three  important  abnormal 
presentations. 

874.  See  Q.  430  to  469. 

875.  Mention  the  principal  causes  of  sterility  in  woman, 
and  state  whoi  may  be  done  to  promote  fertility. 

875.  See  Q.  852  to  859. 

876.  Define  puerperal  eclampsia.  State  the  probable 
causes,  the  symptoms,  and  the  management  of  puerperal 
eclampsia. 

876.  See  Q.  630  to  648. 

877.  What  is  cystitis?  State  the  causes  of  cystitis  in  the 
female  and  give  its  treatment. 

877.  Crockett's  Gynecology,  pages  146  to  150. 
(107) 


108  APPENDIX. 

878.  State  the  principal  causes  of  puerperal  infection. 
What  means  should  he  taken  to  prevent  puerj)eral  infection? 

878.  See  Q.  749  to  770. 

879.  Give  the  symptoms,  diagnosis,  and  treatment  of 
inversion  of  the  uterus. 

879.  See  Q.  560  to  564. 

880.  (a)  Enumerate  some  of  the  most  frequent  causes  of 
dystocia,  and  (b)  differentiate  uterine  inertia  and  obstructed 
labor. 

880.  fa)  See  A.  470  to  486  (d) ;  (b)  See  Q.  486  to  496,  and 
Q.  511  to  514. 

881.  (a)  Mention  the  important  diameters  of  the  foital  head 
at  term  and  give  their  measurements,  (b)  State  similar 
diameters,  with  measurements,  of  the  bony  pelvis. 

881.  (a)  See  A.  109  to  118  fd) ;  (b)  See  A.  100  to  108  (i). 

882.  Describe  in  detail  the  liquor  amnii  and  give  its 
functions. 

882.  See  Q.  268  to  271. 

883.  Describe  a  condition  requiring  the  use  of  an  anaes- 
thetic during  labor.  State  the  kind  of  ancesthetic  preferred 
and  give  the  method  of  administering  it. 

883.  See  Q.  346  to  359. 

884.  Mention  the  forms  of  asphyxia  neonatorum  and  give 
methods  of  resuscitation. 

884.  See  Q.  382  to  390. 

885.  (a)  How  may  the  date  of  labor  be  estimated?  (b) 
What  medico-legal  complications  may  result  from  an  erroneous 
diagnosis  of  pregnancy? 

885.  (a)  See  Q.  174  to  176  fb) ;  (b)  See  Q.  866. 


109  APPENDIX. 

Questions  asked  May,  1903. 

886.  (a)  Give  an  anatomical  description  of  the  uterus,  (b) 
including  the  arrangement  of  its  muscular  fibres. 

886.  (a)  See  Q.  8  and  9;  (b)  ^'The  uterus  is  essentially  a 
muscular  organ.  It  is  lined  with  mucous  membrane  and 
partially  invested  with  peritoneum.  Its  walls  are  of  an 
average  thickness  of  three-eighths  of  an  inch.  Though  the 
fibres  interlace  in  such  a  manner  as  to  be  inseparable 
except  in  the  gravid  uterus,  anatomists  are  almost  univer- 
sally agreed  that  they  are  arranged  m  three  distinct  layers. 
They  are  of  the  unstriated  or  involuntary  variety,  and 
have  interpose'd  between  them  connective-tissue  cells.  The 
external  muscular  layer  or  stratum  is  exceedingly  thin, 
and  can  be  demonstrated  upon  such  parts  of  the  uterus 
onty  as  are  covered  by  the  peritoneum,  and  with  this  it  is 
intimately  connected.  The  fibres  of  this  layer  pass  from 
the  anterior  and  the  posterior  surfaces  and  from  the  fundus 
upon  the  Fallopian  tubes,  the  round  and  the  ovarian 
ligaments,  and  accompany  such  parts  of  the  peritoneum 
as  form  the  broad  and  the  utero-sacral  ligaments.  The 
internal  muscular  layer  is  so  intimately  connected  with  the 
mucous  membrane  as  to  be,  by  some,  described  with  it, 
for,  except  in  the  cervix,  there  exists  in  the  uterus  no 
submucosa.  The  fibres  of  this  layer  have  a  chcular 
arrangement.  They  are  augmented  at  the  orifices  of  the 
Fallopian  tubes,  at  the  os  externum,  and  at  the  os  internum. 
Those  at  the  os  internum  are  considered  as  forming  a 
s])hincter  muscle.  The  middle  muscular  layer  constitutes 
much  the  greatest  part  of  the  structm^e  of  the  uterus,  and 
is  continuous  with  the  muscular  coat  of  the  vagina.  It  is 
of  an  average  thickness  of  one-quarter  of  an  inch.  The 
fibres  have  no  definite  arrangement,  but  interlace  in  every 
direction.  They  develop  in  size  enormoush^  during  gesta- 
tion. This  stratum  is  exceeclingty  vascular."  (Jewett's 
Practice  of  Obstetrics.) 


13 


110  APPENDIX, 

887.  Describe  physiologically  the  impregnation  of  the 
ovum. 

887.  See  Q.  43  to  62  (e),  and  (g). 

888.  Mention  the  average  duration  of  'pregnancy  and  state 
the  methods  by  which  the  date  of  labor  may  be  prognosticated. 

S^^.  See  Q.  174  to  179  (b),  and  (c), 

889.  Give  the  causes,  symptoms,  and  treatment  of  asphyxia 
neonatorum. 

889.  See  Q.  383. 

890.  Give  the  treatment  of  the  pernicious  vomiting  of  preg- 
nancy. 

890.  See  Q.  192  to  198  (b). 

891.  Under  what  conditions  is  version  indicated?  What 
methods  are  used  in  the  operation? 

891.  See  Q.  697  to  711. 

892.  Describe  the  knee-chest  posture  and  merdion  some  of 
the  reasons  for  its  employment. 

892.  See  Q.  865. 

893.  How  should  a  woman  in  the  puerperal  state  be 
catheterized? 

893.  See  Q.  363. 

894.  Describe  in  detail  the  delivery  of  the  placetita  accord- 
ing to  the  method  of  Crede. 

894.  See  Q.  318,  321  and  322. 

895.  Describe  and  differentiate  hydrosalpinx,  pyosalpinx, 
hcemato  salpinx. 

895.  Crockett's  Gynecology,  pages  112  to  116,  and  table 
on  page  111.  » 

896.  Give  the  approximate  length  of  the  foetus  at  the  sixth, 
the  seventh,  the  eighth,  and  the  ninth  calendar  months  of  ges- 
tation. 

896.  King's  Manual  of  Obstetrics,  page  bS^. 


Ill  APPENDIX. 

897.  Give  the  management  of  a  case  of  rigidity  of  the  os 
uteri  during  labor. 

897.  See  Q.  501  to  504  (b). 

898.  State  when  obstetric  ancesthesia  is  admissible.  How 
should  the  ancesthetic  be  administered? 

898.  See  Q.  346  to  349. 

899.  How  may  laceration  of  the  cervix  be  recognized  and 
how  shoidd  it  be  treated? 

899.  See  Q.  578;  and  King's  Manual  of  Obstetrics, 
page  473. 

900.  Mention  the  dangers  of  puerperal  sepsis  and  give  its 
prophylactic  treatment. 

900.  See  Q.  749  to  770. 

Questions  asked  June,  1903. 

901.  Give  the  anatomy  of  the  female  reproductive  organs. 

901.  See  Q.  17  and  18. 

90S.  (a)  Mention  the  several  processes  relating  to  fecun- 
dation, (b)  including  the  changes  in  the  ovum  following 
fertilization. 

902.  (a)  See  Q.  43  to  78  (g) ;  (b)  See  Q.  43  to  78  (1). 

903.  Describe  the  foetal  circulation. 

903.  King's  Manual  of  Obstetrics,  page  101. 

904.  Describe  the  changes  that  occur  in  the  genital  organs 
after  pregnancy. 

904.  See  Q.  123. 

905.  (a)  Define  multiple  pregnancy,  (b)  State  the  causes 
and  signs  of  multiple  pregnancy  and  show  how  it  may  compli- 
cate labor. 

905.  (a)  See  Q.  525  (a);  (b)  See  Q.  528  to  534  (b),  and 
(d);  for  the  ''causes"  see  King's  Manual  of  Obstetrics, 
page  478. 


112  APPENDIX. 

906.  Describe  the  mechanical  and  the  surgical  treatment 
of  retrodisplacement  of  the  uterus. 

906.  Crockett's  Gynecology,  pages  248  to  259. 

907.  Give  (c)  the  symq)toms,  (a)  varieties,  and  dangers  of 
-placenta  prcevia.  (b)  State  the  methods  of  dealing  with 
placenta  prcevia. 

907.  See  Q.  579  to  594;  for  ^'dangers"  see  King's 
Manual  of  Obstetrics,  page  443. 

908.  Give  the  causes,  pathology,  symptoms,  diagnosis,  and 
treatment  of  vaginitis. 

908.  Crockett's  Gynecology,  pages  ^^  to  SS. 

909.  Give  the  causes,  pathology,  symptoms,  diagnosis,  and 
treatment  of  chronic  simple  endometritis. 

909.  Crockett's  Gynecology,  pages  98  to  110. 

910.  Define  vaginismus  and  give  its  causes,  pathology,  and 
treatment. 

910.  See  Q.  806  to  808. 

911.  Describe  the  classic  Ccesarean  section,  give  its  modifica- 
tions and  state  the  indications  for  the  application  of  each. 

911.  See  Q.  720  to  725. 

91S.  How  may  it  be  ascertained  that  a  fibroid  tumor 
complicates  labor?     Give  the  management  of  this  condition. 

912.  King's  Manual  of  Obstetrics,  pages  508  and  509. 

913.  Under  what  conditions  is  version  to  be  performed? 
Give  the  technique  of  version. 

913.  See  Q.  697  to  711. 

914.  Define  pelvimetry  and  state  its  purpose.  Describe 
the  technique  of  pelvimetry. 

914.  See  Q.  547  and  548. 

915.  Give  the  symptoms,  diagnosis,  and  treatment  of  rupture 
of  the  uterus  complicating  labor. 

915.  See  Q.  565  to  577. 


SECOND     EDITION.      THOROUGHLY     REVISED 

JEWETT'S   OBSTETRICS 

The  Pkinciples  and  Pbactice  of  Obstetrics.  By  Eminent  American 
Authors.  Edited  by  Charles  Jettett,  M.D.,  Professor  of  Obstetrics  in  the 
Long  Island  College  Hospital,  Brooklyn,  X.  Y,  In  one  handsome  octavo 
volume  of  775  pages,  with  44-5  engravings  in  black  and  colors  and  36  full- 
page  colored  plates. 

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Dr.  Jewett,  the  editor,  has  long  been  recognized  as  a  keen  and  scientific  observer,  an 
accurate,  forcible  and  concise  writer,  as  well  as  a  most  successful  teacher  of  obstetrics. 
It  is  pre-eminently  a  practical  treatise,  suited  to  the  needs  of  medical  classes,  while,  at 
the  same  time,  it  furnishes  a  concise,  ccmprehensive  and  trustworthy  guide  to  the  practi- 
tioner. We  regard  this  as  being  one  of  the  most  scientific  and  thoroughly  modem  treatises 
upon  this  important  subject  in  use  to-day. — American  Gynecological  and  Obstetrical  Journal. 

KING'S   MANUAL  OF   OBSTETRICS 

NINTH     EDITION 

A  Maxuai,  of  Obstetrics  By  A.  F.  A.  King,  M.D.,  Professor  of 
Obstetrics  and  Diseases  of  Women  in  the  Medical  Department  of  the  Colum- 
bian University,  Washington,  D.C.,  and  in  the  University  of  Vermont,  etc. 
Eighth  and  revised  edition      12mo. ,  622  pages,  with  275  illustrations. 

Cloth,    $2. SO,  net 

From  first  to  finish  it  is  thoroughly  practical,  concise  in  expression,  well  illustrated, 
and  includes  a  statement  of  nearly  every  fact  of  importance  discussed  in  obstetric 
treatises.  The  well-arranged  index  renders  the  book  useful  to  the  practitioner  who  is 
in  haste  to  refresh  his  memory  or  learn  a  fact. — Georgia  Journal  of  Medicine  and  Surgery. 

It  is  the  best  of  its  kind,  an  eminently  practical  handbook  on  midwifery,  and  fully 
up  to  date. — The  Chicago  Medical  Recorder. 

FINDLEY'S   GYNECOLOGICAL   DIAGNOSIS 

A  Text-Book  of  Gynecological  Diagnosis,  for  the  Use  of  Prac- 
titioners AND   Students.      By   Palmer    Findley,   M.D.,   Associate  in 
Obstetrics  and  Gynecology  in  Rush  Medical  College,  Chicago.     Octavo,  493 
pages,  with  210  engravings  and  45  plates,  in  black  and  colors. 
Cloth,  $4. SO,  net;    Leather,  $S  SO,  net 

CROCKETT'S   GYNECOLOGY 

A  Pocket  Text- Book  of  Diseases  of  Women.  By  Montgomery  A. 
Crockett,  A.B.,  M.D. ,  Adjunct  Professor  of  Obstetrics  and  Clinical  Gyne- 
cology, Medical  Department,  University  of  Buffalo,  N.  Y.  In  one  12mo. 
volume  of  368  pages,  with  107  illustrations. 

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For  sale  by  all  dealers  in  Medical  Books  or  sent  carriage  paid  to  any 
address  on  receipt  of  price. 

LEA    BROTHERS   &   CO. 

PUBLISHERS 
706-8-10   SANSOM    STREET  111     FIFTH    AVENUE 

PHILADELPHIA  NEW    YORK 


Annex 


